Foreign matter of a nose — the alien object which incidentally got into a nose cavity: bead, berry stone, sunflower seed, fine detail of a toy, mosquito or other insect, piece of a tree, plastic, food, cotton wool or paper. The foreign matter of a nose can be asymptomatic. But more often it is shown by pain, a unilateral congestion of a nose and allocations from the struck half of a nose. The data of the anamnesis, results of otolaryngologic survey and a rinoskopiya given to KT and a X-ray analysis help to diagnose a foreign matter of a nose. Treatment of a foreign matter of a nose consists in its earlier elimination by blowing, endoscopic or surgical removal.
Foreign matter of a nose
Most often experts should face foreign matters of a nose in the field of children's otolaryngology. Children, playing, purposely enter to themselves and each other into a nose various objects. The foreign matters which got thus into a nose cavity, as a rule, are in the lower nasal course. They make 80% of total number of foreign matters of a nose. Alien objects, by one end put in a nasal partition, and to others — in the lower nasal sink are less often observed. The foreign matter of a nose which got to it in a random way can have any localization.
Pathogenesis of a foreign matter of a nose
Hit of a foreign matter in a nose can come in the natural way from the environment through nostrils and from a throat through hoanalny openings. The foreign matters of a nose which got through nostrils occur generally at children of preschool age who for the sake of interest pawn to themselves in a nose various small items. In a random way the live organisms which are in the inhaled air or in water from open sources and reservoirs can get into a nose. In some cases the foreign matter of a nose has the yatrogenny nature and represents the wadded tampon left in a nose or the broken-off part of a surgical instrument used during otolaryngologic manipulations or operations (a septoplastik, correction of an atresia Joán, a resection of a nasal sink, removal of a tumor of a cavity of a nose and so forth).
The foreign matter of a nose can turn out to be consequence of a poperkhivaniye during food or vomiting. At the same time the pieces of food or other objects which are in a throat cavity can be thrown in a nose through the openings Joán connecting a nose to a throat. Emergence of a foreign matter of a nose is also possible at an injury of a nose and damages of the structures of the person adjoining to it. At the same time the glass splinter, a piece of a tree, a sharp object, a bullet or a free fragment of a bone can become a foreign matter of a nose.
Classification of foreign matters of a nose
Foreign matters of a nose are classified by the nature on: inorganic (pebbles, beads, beads, cotton wool, glass pieces, plastic details), metal (coins, screws, details of the metal designer, a needle, a nail, the button, splinters of fire shells), organic (seeds of various plants, peas, small haricot, pieces of vegetables and fruit, stones of fruits, parts of the products used in food), live (insects, larvae, bloodsuckers, ascarids).
Depending on that, the foreign matter of a nose at a radiological research is visualized or not, allocate X-ray contrast and X-ray low-contrast foreign matters. X-ray contrast bodies are metal objects, glass, stones, buttons, parts of toys.
Symptoms of a foreign matter of a nose
Usually hit of an alien object in a nasal cavity is followed by reflex sneezing, watery allocations from one half of a nose and dacryagogue. However these symptoms quickly pass and further the foreign matter of a nose can not disturb the patient at all. The small foreign matter of a nose having a smooth surface can not give any clinical manifestations during the long period. Cases when rough foreign matters of a nose and even objects with acute angles long enough did not cause complaints of the patient are known. Over time as a result of irritation and chronic traumatizing mucous the inflammatory reaction leading to emergence of clinical symptoms in the form of nose pain, the mucous or separated from one half mucopurulent nose can arise an alien subject of a nose. The puffiness resulting from an inflammation mucous a nose causes difficulty of nasal breath.
In other cases the foreign matter of a nose at once, from the moment of the hit in a nose, causes different discomfortable feelings: tickling, irritation, feeling of a foreign subject, pain in the struck half of a nose. The pain connected with a foreign matter can be followed by irradiation in a forehead, a cheek or a throat. The most intensive pain syndrome is characteristic of a foreign matter of a nose with keen edges or ledges. Such objects are capable to cause considerable damage of internal tissues of nose with developing of nasal bleeding. In certain cases the foreign matter of a nose is followed by headaches, dizziness. The expressed nose pain can lead to a sleep disorder, the increased irritability, at children — to concern, tearfulness and frequent whims.
For a foreign matter of a nose the triad of symptoms is classical: pain, allocations from a nose and its congestion. The characteristic distinguishing these symptoms from displays of rhinitis, allergic rhinitis and sinusitis is their unilateral character. At children most often the foreign matter of a nose is followed only by cold with the allocations going only from one half of a nose. In some cases at a deep breath the foreign matter of a nose can migrate in a throat or a throat. Then in a clinical picture symptoms of a foreign matter of a throat or a foreign matter of a throat appear.
Separate foreign matters of a nose at stay in it long time undergo some changes. So, peas and fasolina from the damp environment of a nose begin to increase in sizes, often completely blocking nasal breath of that half of a nose in which are. Some foreign matters of a nose break up to parts over time, will be softened or completely decay. If the foreign matter of a nose keeps the initial look, then it can become a kernel of the nasal stone which is formed at adjournment of the salts which are contained in a secret mucous a nose. At development of granulyatsionny fabric which growth is provoked by continuous traumatizing mucous is long the existing foreign matter of a nose perhaps. The developed granulations quite often hide a foreign matter of a nose, complicating its visualization and diagnostics.
Complications of a foreign matter of a nose
The difficulty of nasal breath and violation of ventilation caused by a foreign matter of a nose can lead to emergence of inflammatory changes in additional bosoms of a nose. At long finding of a foreign matter in a nose the ulceration mucous, development of polipozny growths, a necrosis of a nasal sink, suppuration of a plaintive bag, violation is possible from slezoprovodyashchy ways. Accession of a secondary infection causes development of a purulent rinosinusit, is very rare — osteomyelitis of bone structures of a nose. In hard cases the foreign matter of a nose can punch its wall.
Diagnostics of a foreign matter of a nose
In most cases the foreign matter of a nose can be diagnosed by the otolaryngologist on the basis of the anamnesis, results of survey of a cavity of a nose and a rinoskopiya. Difficulties of diagnostics arise at children of younger age in whose anamnesis there can be no instruction on hit of an alien object in a nose. Difficult it is found the existing foreign matter of a nose is long. During a rinoskopiya it can not be visualized because of the expressed hypostasis, inflammatory changes mucous or the formed granulations. In such cases apply palpation to detection of a foreign matter of a nose the metal probe. However it allows to reveal only dense alien objects.
Treatment of a foreign matter of a nose
Removal of a foreign matter of a nose has to be carried out as soon as possible, the puffiness and inflammatory reaction complicating its extraction did not manage to develop yet. The foreign matter of a nose which recently got to it can be eliminated by simple blowing. The patient ask to gather more air, to close a mouth, to cover with a finger a healthy nostril and to strongly blow the gathered air. Such way can be applied only at children of advanced age and at adults.
At adults after unfortunate attempt of blowing of a foreign matter of a nose in the natural way and at small children make endoscopic removal of a foreign matter. At adults the procedure is carried out with application of local anesthesia, at small children the general anesthesia for this purpose can be required. In rare instances when endoscopic removal was not crowned with success, the foreign matter is deleted in the surgical way.
If necessary in addition apply washing of a cavity of a nose solutions of anti-septic tanks, an instillation in a nose of vasoconstrictive drops, drainage and washing of okolonosovy bosoms, carry out treatment of complications.