Paediatric ENT & Ear, Nose and Airway Foreign Bodies
Recognise hidden foreign bodies, protect the first removal attempt and support childhood hearing.
Quick revision ↓ Medical Dictionary
01Unilateral clues
Persistent offensive unilateral nasal discharge in a child suggests a retained foreign body until assessed. Ear objects may cause pain, discharge or hearing change, while some are found incidentally. Ask about the object and timing without blaming the child or caregiver. Examine safely and determine whether a button battery or another high-risk object is possible.
02Safe removal planning
The first well-planned attempt offers the best chance of atraumatic removal. Repeated blind attempts can push an object deeper, cause bleeding and reduce cooperation. Removal method depends on the object, site, drum integrity and available expertise. Do not irrigate batteries or objects that may swell, and escalate when safe removal cannot be achieved with appropriate skill and equipment.
03Batteries and urgent objects
A button battery in the nose or ear can damage tissue rapidly and needs immediate removal through an emergency specialist pathway. Do not wait for pain or visible burns to develop. Multiple magnets or other hazardous objects also need expert assessment. Prevention includes secure battery compartments and keeping small objects away from young children.
04Inhaled foreign body
A choking episode followed by persistent cough, unilateral wheeze or reduced air entry can suggest aspiration even after initial distress settles. A normal examination or plain radiograph does not exclude every airway foreign body. Acute choking requires the age-appropriate emergency response; ongoing suspicion requires urgent specialist assessment, often including a bronchoscopy decision.
05Development and family support
Hearing loss, recurrent middle-ear disease and nasal obstruction can affect speech, behaviour and school participation. Use age-appropriate audiology and explain the plan in accessible language. Ensure follow-up is feasible and involve school or therapy services when relevant. Do not attribute language delay or inattention to behaviour alone before considering hearing and other developmental needs.
High-Yield Revision
- Offensive unilateral nasal discharge suggests a foreign body.
- Button batteries need immediate action even without pain.
- A normal chest radiograph does not exclude every inhaled object.
Common Pitfalls
- Repeated blind removal attempts.
- Ignoring hearing assessment in a child with speech concerns.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.