Presentation and management of nasal foreign bodies at a tertiary children's hospital in an American metro area

ObjectivesTo examine rates of otolaryngology intervention in children presenting to our emergency department with nasal foreign bodies, factors associated with otolaryngology involvement, rates of complications, and details on nasal button battery exposure.MethodsAll patients presenting with a nasal foreign body to Children's Hospital Colorado from 2007 to 2012 were identified. Factors leading to referral to otolaryngology and operative intervention were examined, as well as complications.Results102 patients were included. 36 (35%) patients were referred to the otolaryngology clinic, of which 58.9% required operating room intervention. 66 (64.7%) children had their nasal foreign bodies removed in the emergency room, however 30 (45%) of these were removed by an otolaryngology resident or attending physician. Overall, 64.7% of nasal foreign bodies required removal by otolaryngology. Of the 15 objects removed in the operating room, six were button batteries. No septal perforations occurred as a result of nasal button battery exposure. Multivariable logistic regression showed two significant predictors of OR removal: age and disc shaped objects.ConclusionWhile emergency department providers are comfortable attempting removal of nasal foreign bodies, there was a high rate of otolaryngology intervention. Based on this data, there is a need to educate emergency room providers on nasal anatomy and techniques for nasal foreign body removal.