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Intranasal foreign bodies: A 10-year analysis of a large cohort, in a tertiary medical center
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  • Ofir Zavdy,
  • Igor Vainer,
  • Nataly London,
  • Tomer Menzely,
  • Roy Hod,
  • Eyal Raveh,
  • Dror Gilony
Ofir Zavdy
Rabin Medical Center
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Igor Vainer
Rabin Medical Center
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Nataly London
Rabin Medical Center
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Tomer Menzely
Rabin Medical Center
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Roy Hod
Rabin Medical Center
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Eyal Raveh
Rabin Medical Center
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Dror Gilony
Rabin Medical Center
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Abstract

Objective: To describe the occurrence, clinical presentation and management, of pediatric nasal foreign bodies, and to assess various risk factors for complications. Methods: A retrospective analysis of a computerized patient directory of 562 children admitted to the emergency department (ED) in a tertiary pediatric hospital during a 10-year period (Jan 2010-Dec 2019), with a witnessed NFB upon physical examination. Results: Upon admittance to the ED, most of the children (82%) were asymptomatic. Among the symptomatic children (18%), the primary symptoms were nasal discharge (10%), epistaxis (8%) and pain (4%). Younger children (under age 4 years) were more likely to insert organic materials, compared to older children. Younger children were also admitted sooner to the ED and were more likely to present with nasal discharge. The overall complication rate was 5%. None of the children had aspirated the NFB. Complications included infection (2%), necrosis (0.7%), septal perforation (0.5%), deep mucosal laceration (1.5%) and loss of NFB (1.9%). Significantly higher rates of symptoms and complications were associated with button batteries. Increased risk for complications were observed according to NFB-type, multiple attempts to remove NFB, posterior insertion of NFB and left-side insertion. Conclusions: NFB in children are common. Mostly, patients are asymptomatic, therefore a high index of suspicion is required, for quick diagnosis and safe removal, without complications.