Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Fortunately, most people (adults) can and will tell their doctor about an object's presence in their nose.
Typically, foreign items in the nose result in complaints of pain or difficulty breathing through that side of the nose.
Nasal bleeding is also a common symptom of a foreign body in the nose because the tissues of the nose can be easily scratched. Much of this blood can drip down the back of the throat and be swallowed. Because blood is quite nauseating,
the person may vomit, which can appear black or bloody, depending on how long the blood remains in the stomach.
The nasal space connects to the back of the mouth, so it is also possible for an object to be pushed back into the throat.
Individuals may swallow the object or choke on it. Complaints of choking, wheezing, difficulty breathing, or inability to talk should prompt an evaluation of the entire nose and throat in addition to the lungs so that foreign bodies will not be overlooked.
Gathering information in regard to what kind of foreign object it may have been
will assist the health care practitioner to determine if an X-ray will show the
object (for example, is the object radiopaque [metal]?)
Some individuals, especially children, who are motivated to place something in their nose might also think it is fun to put something in the other side of their nose as well as in one or both ears. A doctor will check all the likely places if there is a suspicion of additional foreign bodies.
Moreover, children have been known to place objects in their younger siblings nose, ears, and other places.
Infection is another common symptom of a foreign object in the nose. Lost or
forgotten tissue paper is a common source of such a problem. This scenario is
not uncommon in adults and children. People will typically complain of
continuing nasal discharge from one side of the nose. Many of these people have been treated with
one or more antibiotics. Unfortunately, antibiotics alone will not cure this condition until the offending object is removed. In addition,
the sinuses are all connected to the nasal passages. Because a foreign body in the nose will frequently
become infected and block the drainage sites of the sinuses,
sinusitis should also raise the question of a foreign object inside the nose.
Although a person can usually sense the presence of something out of the ordinary in
their nose, it may be confused with nasal congestion, so small objects or torn tissue paper can easily go undetected.
A foul odor can be a sign of a foreign body that has been in the nose for a
period of time. The object can manifest itself by producing
bad breath or a foul odor
from the nose, possibly linked to a nasal discharge associated with the foreign
object.
The skin under the nose may become raw from the continuous discharge or from
frequent wiping. Impetigo is an infection of the skin that is commonly associated with this problem. Impetigo typically appears as a raw rash with faint yellow, crusty material over it. Impetigo just in this area must prompt a thorough evaluation of the nose to ensure that the nose is clear.
Nasal foreign bodies that require removal are relatively common among pediatric patients and may also be seen in adult patients, most often those with psychiatric disease or developmental delay.
