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 Table of Contents  
CASE REPORT
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 15-17

Seventeen-year-old asymptomatic foreign body in the nose: Case report


Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey

Date of Web Publication17-Feb-2014

Correspondence Address:
Bilsev Ince
Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, Konya
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2148-7731.127222

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  Abstract 

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 26];1:15-7. Available from: http://www.imjsu.org/text.asp?2014/1/1/15/127222


  Introduction Top


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. [1] Non-removal of the nasal foreign body or missing it may cause a foul-smelling purulent nasal discharge, septal perforation, and necrosis of bones. [2]

Several symptoms may be present in the case of a nasal foreign body. These symptoms include nasal discharge, [3] epistaxis, [2] infection, [4],[5],[6] halitosis, [7] foul breath or body odor, [8] and chronic sinusitis. [1] 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 Top


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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Figure 3: The foreign bodies

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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 Top


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. [9] 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. [2] 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. [10] However, a nasal foreign body can rarely cause halitosis, [7] foul body odor, [8] facial cellulitis, [4] and infections such as epiglottitis [5] and tetanus. [6]

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. [1] 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. [3] 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.

 
  References Top

1.Kelesidis T, Osman S, Dinerman H. An unusual foreign body as cause of chronic sinusitis: A case report. J Med Case Rep 2010;26:4:157.  Back to cited text no. 1
    
2.Ohhashi S, Hattori Y, Tsurukubo K, Nakajima Y, Kashiwado I. Case report of a foreign body in the nasal cavity: Experimental research on limited damage. Nihon Jibiinkoka Gakkai Kaiho 1993;96:387-93.  Back to cited text no. 2
[PUBMED]    
3.Dudvarski Z, Pendjer I, Janoseviæ LJ, Djukiæ V, Dimitrijeviæ M, Arsoviæ N, et al. Overlooked nasal foreign body with a 48-year latent period. Acta Chir Iugosl 2008;55:113-6.  Back to cited text no. 3
    
4.Waldman LA. Facial cellulitis caused by unrecognized foreign body. Oral Surg Oral Med Oral Pathol 1979;48:408-9.  Back to cited text no. 4
[PUBMED]    
5.Oh TH, Gaudet T. Acute epiglottis associated with nasal foreign body: Occurrence in a 30-month-old girl. Clin Pediatr 1977;16:1067-8.  Back to cited text no. 5
    
6.Sarnaik AP, Venkat G. Cephalic tetanus as a complication of nasal foreign body. Am J Dis Child 1981;135:571-2.  Back to cited text no. 6
[PUBMED]    
7.Atmaca S, Zenciroglu A. Intranasal foreign body without nasal discharge presenting with halitosis. KBB-forum 2003;2(3). www.KBB-Forum.net.  Back to cited text no. 7
    
8.Katz HP, Katz JR, Bernstein M, Marcin J. Unusual presentation of nasal foreign bodies in children. JAMA 1979;241:1496.  Back to cited text no. 8
[PUBMED]    
9.Tay AB. Long-standing intranasal foreign body: An incidental finding on dental radiograph: A case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:546-9.  Back to cited text no. 9
[PUBMED]    
10.Zanetta A, Cuestas G, Rodríguez H, Quiroga V. Septal perforation in children due to button battery lodged in the nose: Case series. Arch Argent Pediatr 2012;110:430-4.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]


This article has been cited by
1 An Asymptomatic Foreign Body in the Nose in an Eighteen-Year-Old Patient: Button Battery
Merih Onal,Gultekin Ovet,Necat Alatas
Case Reports in Surgery. 2015; 2015: 1
[Pubmed] | [DOI]



 

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