Here is a pearl about nasal foreign bodies:
The nose is the MC site of fb insertion, seen mostly in children <5 years. Most of the time, the risk of aspiration and complications are low. However, if the fb is a button battery or a set of paired disc magnets, the risks can be more significant. Generally you should know if the object is animal, vegetable, mineral, or toy prior to removal. Sometimes, it is impossible to know.
Symptoms of nasal foreign bodies include:
Mouth breathing
Unilateral malodorous purulent discharge
Epistaxis
Sinusitis refractory to antibiotics
Treatment methods include:
Negative pressure – suction catheter technique
“Mothers kiss” which involves a parent insufflating a short burst of air into the child’s mouth while occluding the unaffected nares.
High pressure air through suction tubing – new technique detailed via ACEP: https://www.acepnow.com/article/perform-positive-pressure-technique-nasal-foreign-body-removal/
Placing a small foley in the affected nares, past the obstruction, inflating the balloon, and then pulling back. This should dislodge the object. Balloon catheters may also be used to prevent posterior migration of a foreign body while other methods of removal are used.
Mechanical retrieval with your ENT colleagues or with alligator forceps if you can see it.
This reference reviews all techniques: https://emj.bmj.com/content/17/2/91
