Introduction
Children, particularly under 3, have a tendency to hide foreign objects in their noses or ears.
If this happens to older kids, behavioral problems should be considered.
Often a foreign body will not be immediately apparent as they can be inert and might only be detected at routine ear inspection. Nasal foreign bodies often declare themselves with unilateral foul smelling discharge, but please see Primary Care Management as recently inserted objects can sometimes be removed.
Urgent intervention is required if the foreign body is a button battery as this can be immensely destructive.
Less urgent are organic materials but they can be irritating.
Discuss with on call team:
- Emergency: button batteries
- Urgent: organic material
Ears: Often incidental finding
Nose: foul smelling unilateral nasal discharge
The on-call team will consider review and further appropriate management.
Fresh nasal foreign bodies can often be dislodged using the “mother’s kiss”. This works in about 60% of cases and even if not entirely successful might dislodge to foreign body enough to facilitate removal.
To perform this, the parent places their mouth around the child’s open mouth, occludes the nostril without the foreign body and blows into the child’s mouth. Gently at first until resistance is encountered (child’s glottis closes), then short, sharp puffs.
Inert ear foreign bodies can often be removed by gentle syringing in the practice. If the foreign body is a living insect, oil instillation will suffocate and kill them.
Not all foreign bodies, particularly in ears, need to be removed. Small, inert foreign bodies, for example plastic beads, often migrate out of the ear with wax or during water exposure (swimming, bathing, shower).
