FOREIGN BODIES IN ENT

Foreign body in ENT is one of the most encountered problems in daily practice. Foreign body means any object that does not belong to/or is not a part of our body in a region it is not meant to be in, where it can cause harm by its mere presence if immediate medical attention is not sought.

Foreign body in the nose

Coin in Cricopharynx

What are these foreign bodies?

These are commonly available substances in our surrounding. These substances are either small objects or organisms. These small objects can either be inanimate or animate. The common inanimate objects include batteries, small toys, papers, erasers, dentures, coins, safety pins, buttons, marbles, and seeds. Common animate foreign bodies can vary with geographical location, the most often seen ones being fish bone, chicken bones, maggots, flies, cockroaches, and spiders but in hilly terrain ticks and leeches are also seen.

Button Battery

Leech in nose

Insect In Ear

Who is it common in?

Foreign bodies are common in two age groups: children below five years and older adults. Especially ingestion is more common in these two age groups due to lack of molar teeth, therefore the edibles placed in the mouth are broken down but not chewed which they easily ingest or aspirate. In children it is more when they are running, playing or talking. In adults it can be accidental or intentional. There are also certain disorders which are associated in ingestion of foreign bodies eg: Pica.

What to do when this happens ?

Foreign bodies need to be addressed immediately . It is recommended to seek medical attention and DO NOT attempt home remedies. Foreign bodies anywhere can cause a lot of damage and lead to complications.

What are the symptoms?

1) Foreign body in the airway includes the nasal cavity, larynx, trachea and the bronchus. When the foreign body is present in the nasal cavity the patient can complain of nasal block and nasal discharge(the discharge commonly being unilateral). If present in the lower airway the patient can have difficulty in breathing, cough, pain, stridor, loss of consciousness.

2) When the foreign body is present in the ear there can be severe pain, damage to the tympanic membrane, discharge, irritation, bleeding and ear block sensation.

3) When the foreign body is present in the oral cavity, oropharynx and oesophagus there can be pricking sensation in the region, difficulty in swallowing, pain while swallowing and in case of prolonged duration, abscess formation and migration of the foreign body.

How can we manage ?

The management methods are many and vary depending on the foreign body and the area where they are lodged. With the latest advancement in technology we have better visualization and access to the foreign body with minimally invasive techniques. Radiology is used to locate the position of foreign bodies in required cases. X-ray’s, Computed tomography are more commonly used . MRI can help in certain cases . Radio-opaque foreign bodies are more clearly visualized that radio-lucent foreign bodies.

We can use nasal endoscopy to visualize foreign bodies in the nasal cavity not visible in anterior rhinoscopy and remove it. Similarly otoendoscopy or otomicroscopy can be done to better visualise and remove foreign bodies in the ear to minimise damage to the tympanic membrane. Oesophagoscopy or bronchoscopy is done to visualize and remove the foreign body from oesophagus and trachea/ bronchus respectively. Both flexible and rigid oesophagoscopes and bronchoscopes are available.

Cases scenarios:

Case one

This was a child, 3 years of age, presented to us with complaints of right nasal discharge. On examination there was discharge in thr right nasal cavity, on suction and nasal endoscopy we found a button battery lodged in the cavity with damage to the mucosa around but no erosion of the nasal septum. These need to be addressed immediately as batteries release chemicals which tends to cause extensive damage eroding tissues around them. The foreign body was removed under vision with nasal endoscopy.

Case two

This was a 40 year old male patient who presented to us with complaints of pricking sensation in the throat and difficulty in swallowing since 1 day. Following examination and investigation the chicken bone in the oesophagus was visualised and removed by oesophagoscopy.

Summing Up

At Bangalore ENT Institute & Research Center, our expert doctors offer comprehensive care and management in these emergency situations. To handle any emergencies, contact our doctors at info@beirc.net or on any of our social handles!