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Foreign bodies of the nose and paranasal sinuses

Most often, foreign bodies are found in children who have the habit of putting various objects (beads, buttons, stones, coins, berry seeds, seeds and other small objects) in the nose of themselves or their gullible peers. In adults, foreign bodies get into the nose under random circumstances (for example, during sleep on the hayloft, a piece of straw may be drawn into the nose when breathing). Larger foreign bodies are found only in the mentally ill. As an exception, cases of living foreign bodies — leeches, worms, and larvae — have been described.

Foreign bodies of the nose and paranasal sinuses are possible as a result of gunshot wounds, when wounded with a cold weapon or any household object, the tip of which, fixed in the bone tissues of the nasal cavity, breaks off.

We had to observe a patient with a successful outcome of a wound who, falling from a tree, wounded the medial wall of the orbit with a thin dry knot (the eyeball was not injured). A broken piece of a knot got stuck in a trellised labyrinth. The developed inflammatory process required revision of the wound, as a result of which this radiopaque non-contrast foreign body was discovered and removed.

Foreign bodies introduced through the vestibule of the nose are usually located between the inferior nasal concha and the nasal septum. Foreign bodies that enter the nasal cavity in another way can be localized anywhere.

A foreign body, not extracted in the near future, is gradually overgrown with granulations. The carbonic and phosphate salts of calcium falling around it form a nasal stone - rhinolite. Rhinoliths can be of the most diverse shapes and sizes and sometimes form a cast of the nasal cavity.

Symptoms A foreign body entering the nasal cavity reflexively causes sneezing, lacrimation, rhinorrhea.
Gradually, the reflexes fade away and the body adapts to a foreign object. The presence of a foreign body in the nose causes the following symptoms: 1) one-sided nasal congestion, 2) one-sided purulent runny nose, 3) one-sided headaches, 4) nosebleeds.

Diagnosis. Anamnesis, rhinoscopy, sounding and radiography help to establish the presence of a foreign body. The formation of bleeding granulations around a foreign body, narrowing of the nasal passage and purulent discharge can simulate other diseases. Similar symptoms can occur with purulent diseases of the paranasal sinuses, infectious granulomas and tertiary syphilis. In the differential diagnosis, age matters: foreign bodies are more common in children and they have inflammation of the paranasal sinuses, due to their underdevelopment, is an exception.

Treatment. Removal of foreign bodies in fresh cases is not particularly difficult. Sometimes it can be removed by blowing (it is better to instill vasoconstrictor drops before this). If this procedure is unsuccessful, then after anemization and anesthesia of the nasal mucosa, the foreign body can be removed using a tool. The most suitable for this purpose is a blunt hook, which is inserted behind a foreign body and, during the reverse movement, captures and removes it (Fig. 2.4.5). Attempts to remove a foreign body with tweezers can lead to pushing it deep into the nose. It is advisable to remove immobilized living bodies before they are immobilized (by the action of anesthetics), or, in cases with a leech, pour 10% sodium chloride solution into the nasal cavity, which will cause its reduction. Removal of very large foreign bodies is possible only through surgery, the volume of which is determined depending on the size and location of the foreign body.
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Foreign bodies of the nose and paranasal sinuses

    In the nasal cavity and paranasal sinuses, as in other ENT organs, there are benign and malignant neoplasms, very diverse in morphological structure and clinical manifestation. A distinct border is often impossible to draw with many benign and malignant tumors. Modern classifications of tumors, including the nose and paranasal sinuses, are bulky and
    The study of the nose and paranasal sinuses, after identifying the needles and clarifying the anamnesis, begins with an external examination and palpation. Upon examination, pay attention to the condition of the skin and soft tissues, the absence or presence of defects, the symmetry of both halves of the face, as well as the shape of the external nose. Palpation should be done carefully. With soft hand movements, the presence or
  3. Malignant tumors of the nose and paranasal sinuses
    Malignant diseases of this localization - cancer and isarcoma, as a rule, are primary. They are relatively rare, more often in middle-aged and elderly men. Most often, the primary malignant process affects the maxillary, then the ethmoid, frontal and sphenoid sinuses. Rarely, the nasal septum is the source of the malignant tumor. Malignancy
  4. Clinical physiology of the nose and paranasal sinuses
    Distinguish between upper and lower respiratory tract. The nose and paranasal sinuses, pharynx with the oral cavity and larynx belong to the upper respiratory tract, the trachea, bronchi with bronchioles of the alveoli - to the lower. Normal for a person is breathing through the nose. The nose performs, in addition to the respiratory, protective, resonant and olfactory functions, and also participates in the regulation of the depth of breathing and lacrimation,
    The nose and its paranasal sinuses, being the upper part of the respiratory tract, play an important role in the interaction of the body with the environment, while performing a number of interrelated physiological functions. The following nasal functions are distinguished: 1) respiratory, 2) protective, 3) resonator (speech) and 4) olfactory. In addition, the nose, as an important element in the formation of a single ensemble of the face, is endowed with and
  6. Research methods for the nose and paranasal sinuses
    They produce an external nose nose, places of projection of the paranasal sinuses of the nose on the face. Patch of the external nose: the index fingers of both hands are located along the back of the nose, with light massaging movements they feel the areas of the root, slopes, back and tip of the nose. Palpate the front and lower walls of the frontal sinuses, figuring out the patient's sensations. Thumbs of both hands
  7. Surgery for diseases of the nose and paranasal sinuses
    The most common operations for diseases of the nose and paranasal sinuses include polypectomy, endoscopic interventions in the paranasal sinuses, opening the maxillary sinus (Caldwell-Luc operation), rhinoplasty, septoplasty. Preoperative period Patients often have marked nasal breathing disorders due to polyps, nasal curvature
  8. Fracture of the bones of the nose and paranasal sinuses
    Case: Face asymmetry is determined in the form of deformation of the external nose, sinus front wall sagging, skin damage, palpation pain (sometimes with a crunch, crepitation of bone fragments and air in the subcutaneous tissues), edema, eyelid hematoma and usually bleeding from the nose. Depending on the depth of damage, fractures can be isolated or combined with a head injury
  9. Microendoscopic methods of surgical intervention in the nasal cavity and paranasal sinuses
    There are a number of options for endonasal endoscopic microoperations, however, all methods can be combined into two main varieties - these are classic methods according to Messerklinger and Wiegand, they are designed to restore the natural ventilation and drainage paths, with the smallest changes in the anatomical structures and the maximum gentleness of the mucous membrane. Most widely
  10. Foreign bodies of the nose
    Clinical picture Foreign bodies of the nose are more common in children who, during the game, insert various small objects into their nose (beads, buttons, sunflower seeds, peas, berry seeds, coins, pieces of paper, etc.). Foreign bodies can get into the nose during combat and industrial injuries of the face (shell fragments, bullets, pieces of glass, stones, molten metal), as well as with vomiting
    The upper respiratory tract (nose, paranasal sinuses, pharynx and larynx) perform the most important life-supporting functions, a detailed description of which is given in Part I. The next part is devoted to diseases of these organs. Based on the functional significance in the clinic of each of the organs - reflex, humoral and other connections of these organs with the body as a whole, we can conclude
  12. Foreign bodies of the nasal cavity
    Most often, foreign bodies of the nasal cavity are found in childhood. Children insert various small objects into their nose - buttons, balls, folded pieces of paper, berry seeds, seeds, etc. Foreign bodies can enter the nose through the choanas during vomiting and through the outer surface of the nose in case of injuries. Part of the nasal cavity may be left behind during surgery or after tamponade
  14. Treatment of injuries of the nose and paranasal sinuses at the stages of evacuation
    Self-help and mutual assistance. It is carried out in the manner of self-help, mutual assistance by a nurse or medical examiner. In case of bruises accompanied by nosebleeds, try to stop the bleeding by pressing the wings of the nose to the nasal septum. Snow, ice, or cloth moistened with cold water is applied to the outer nose. With abrasions on the skin or superficial wounds
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