Accidental detection of an intra-nasal foreign body during probing for congenital nasolacrimal duct obstruction

A male patient, aged 3 years, underwent an endoscopic guided irrigation and probing for right sided congenital nasolacrimal duct obstruction (CNLDO). Once the probe was passed through the obstructed nasolacrimal duct, endoscopic guidance was sought to confirm the correct position. During the attempt to gently lift the inferior turbinate (IT, Panel A) to visualize the probe, a round white object slipped from the inferior meatal edge (white arrow, Panel A) of the IT towards the septum. The object was 10 × 10 mms approximately with one surface still in contact with the edge of the inferior turbinate (Panel A). The foreign body was slippery and gently retrieved using the straight Blakesley forceps. Subsequent nasal cavity examination was normal. The planned procedure for CNLDO was uneventful. Following retrieval, the whitish discharge over the NFB was cleared and it was now noted to be grayish black in colour (Panel B) and a material of plant origin (vegetable seed).

Comment

Intranasal foreign bodies (NFB) are not very uncommon in children and are usually noted more in males below 5 years of age.¹ The common NFB reported include synthetic beads, nuts, seeds, beans, broken stationery items and button batteries.² They are most commonly detected either because of reporting by the parents or following nasal symptoms but accidental detection during a procedure is rare.1, 2 Although extremely rare, accidental finding of NFB can be encountered during paediatric lacrimal procedures and adequate care should be ensured in their gentle retrieval and subsequent endoscopic screening to assess for any trauma or complications of the foreign body.

Conflict of interest

The author declares that there is no conflict of interest.