|Year : 2014 | Volume
| Issue : 1 | Page : 15-17
Seventeen-year-old asymptomatic foreign body in the nose: Case report
Bilsev Ince, Mehmet Dadaci, Zeynep Altuntas
Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey
|Date of Web Publication||17-Feb-2014|
Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, Konya
Source of Support: None, Conflict of Interest: None
Several symptoms may be present in the case of a nasal foreign body. These symptoms include nasal discharge, epistaxis, infection, halitosis, foul breath or body odor, and chronic sinusitis. However, the presence of a nasal foreign body without these symptoms remains unreported. In this study, we present a case in which the foreign body stayed inside the patient's nose for 17 years after a trauma without symptoms like nasal discharge, epistaxis, infection, halitosis, foul breath or body odor, and chronic sinusitis.
Keywords: Asymptomatic, nasal foreign body, trauma
|How to cite this article:|
Ince B, Dadaci M, Altuntas Z. Seventeen-year-old asymptomatic foreign body in the nose: Case report. Sifa Med J 2014;1:15-7
|How to cite this URL:|
Ince B, Dadaci M, Altuntas Z. Seventeen-year-old asymptomatic foreign body in the nose: Case report. Sifa Med J [serial online] 2014 [cited 2019 May 23];1:15-7. Available from: http://www.imjsu.org/text.asp?2014/1/1/15/127222
| Introduction|| |
The presence of foul-smelling, purulent nasal discharge may be the sole symptom of a nasal foreign body; its remedy is the removal of the foreign body. However, complications may arise if the nasal foreign body is not quickly detected.  Non-removal of the nasal foreign body or missing it may cause a foul-smelling purulent nasal discharge, septal perforation, and necrosis of bones. 
Several symptoms may be present in the case of a nasal foreign body. These symptoms include nasal discharge,  epistaxis,  infection, ,, halitosis,  foul breath or body odor,  and chronic sinusitis.  However, the presence of a nasal foreign body without these symptoms remains unreported.
In this study, we present a case in which the foreign body stayed inside the patient's nose for 17 years after a trauma without these symptoms.
| Case Report|| |
A male patient was admitted to our clinic complaining of inability to breathe regularly and a nose deformity. Physical examination demonstrated that the left nasal passage was occluded by a deviated septum from the cephalic to caudal ends and the right and the inferior turbinates were hypertrophic. Nasal bones of the patient were asymmetrical and the nose was long with a hump. The nose deformity was caused by an accident when the patient was 2-years-old and the inability to breathe due to the nasal deformity worsened during puberty.
After informing the patient and receiving written informed consent, we performed septorhinoplasty under general anesthesia. During the surgery, a rigid foreign body was detected between the nasal septum and the left nasal bone at the level of the left nasal passage turbinate. The foreign body (2 × 1.3 cm in size) was removed [Figure 1] and [Figure 2]. In addition, two spalls, sized 0.3 and 0.4 cm, were removed from the layer of septal mucoperichondrial [Figure 3].
|Figure 1: A rigid foreign body was detected between the nasal septum and the left nasal bone at the level of left nasal passage turbinate|
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|Figure 2: The foreign body, the sizes of which was 2 × 1.3 cm, was removed|
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Detailed medical history of the patient was recorded. The patient had previously fallen from a height at 2 years of age, and the immediate epistaxis post-accident continued for 2 days. The patient complained of inability to breathe from the right nasal passage since the accident. No form of foul-smelling or purulent discharge had been seen. The patient has no other history of trauma.
No complications were observed during the post-surgery follow-up.
| Discussion|| |
This case study demonstrated that a foreign body can remain in the nose for long periods without causing specific symptoms, such as nasal discharge or sinusitis. In addition, the nasal foreign body was rigid and larger than the nostril, and the 2 × 1.3 cm-sized foreign body at the level of the radix as well as the two 0.3 and 0.4 cm-sized spalls in the layer of the septal mucoperichondrial did not cause septal perforations.
Cases of nasal foreign bodies are frequently seen during childhood, and they are seen in adults because of traumas or mental disorders.  In cases of a nasal foreign body accompanied with foul-smelling, purulent nasal flow, epistaxis is typically present, and removal of the foreign body is the remedy in such cases. Serious complications such as bone necrosis can be seen if the foreign body is not detected and/or removed.  In a study from Spain, 10 cases of nasal foreign bodies, in which septal perforation developed because of a button in the nose, have been reported.  However, a nasal foreign body can rarely cause halitosis,  foul body odor,  facial cellulitis,  and infections such as epiglottitis  and tetanus. 
Early detection and subsequent quick removal of the nasal foreign body are essential. However, cases with nonspecific symptoms, which were detected in this patient after a long period of time, have been reported in the literature. Calcified packing, which remained in the patient's nose for 10 years, was observed in a case diagnosed as chronic sinusitis.  In another case, the reported nasal foreign body was a bead, which stayed asymptomatically in the nasal passage for 48 years, and caused nasal discharge at the end of this period.  The nasal foreign body in our case differs from these reported cases in terms of not causing infections or nasal discharge. The packing, which was defined in other studies, was smoother than the nasal foreign body in our case. However, the 48-year-old bead was smaller than the nasal foreign body in our case; thus, so the entrance was easier.
The foreign body did not cause nasal stuffiness because it was around the level of the radix. However, because of the nasal deviation, the nasal passage was closed up, and the patient complained of nasal stuffiness. Paranasal tomography was not recommended because septum deviation and turbinate hypertrophy were detected by physical examination before the surgery. Therefore, the nasal foreign body was not detected because no imaging method was performed. In addition, the foreign body was not observed by a nasal speculum upon physical examination because it was located at the cephalic septum.
The presence of a nasal foreign body should be considered as a reason for admission because of the patient's complaint of unilateral nasal stuffiness. A foreign body can stay in the nose for long periods without specific complaints, and it should be removed when detected.
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[Figure 1], [Figure 2], [Figure 3]