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American Journal of  
Medical Science and Innovation (AJMSI)

Nasal Foreign Body Presenting as Unilateral Rhinosinusitis with Nasal Polyposis 
Ahmad Rufai Tukur1*, Ahmad M. Aldhafeeri1, Taha Mohammed Aoun1, Faisal Hazaa Abohelaibah1, Benjamin Nonso Nkemjikai1

Volume 4 Issue 2, Year 2025
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v4i2.5858
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: August 02, 2025

Accepted: September 05, 2025

Published: November 17, 2025

Although nasal foreign bodies (FB) are common in pediatric Otorhinolaryngology, their 
long-term complications often go unrecognized. A witnessed nasal FB receives immediate 
intervention and often has no complications. However, an unwitnessed FB may persist in 
the nasal cavity and go unnoticed. This can cause chronic unilateral nasal discharge and 
a bad odor. In rare circumstances, it can present as rhinosinusitis with nasal polyposis. 
This case highlights an unusual polyp-forming scenario, underscoring the importance 
of  considering such diagnoses. This is a case report of  6-years-old female patient who 
presented to our unit with history of  progressive right nasal blockage and discharge of  
about a year duration. She had earlier received medical treatment without improvement. 
Nasal examination revealed reduced patency of  the right nasal cavity, nasal discharge and 
nasal polyps. Computed Tomography (CT) scan revealed opacification of  the right nasal 
cavity and maxillary antrum. Patient was evaluated and booked for Functional Endoscopic 
Sinus Surgery (FESS). Intraoperatively, upon removal of  nasal polyps, FB was incidentally 
discovered and removed. Polyp sent for histology turned out to be inflammatory. Patient was 
seen four weeks postoperative with complete resolution of  the symptoms. Long standing 
nasal FB can elicit inflammatory reaction leading to development of  nasal polyps with 
eventual obstruction of  the nose and maxillary ostium, thereby manifesting with features 
of  rhinosinusitis.

Keywords
Chronic Rhinosinusitis, Foreign 
Body, Pediatric, Sinus Polyposis, 
Sinus Surgery

1 Department of  Otorhinolaryngology, Hafar al Batin Central Hospital, Hafar al Batin, Kingdom of  Saudi Arabia
* Corresponding author’s e-mail: atrufaiggm@gmail.com

INTRODUCTION
Foreign bodies in the nasal cavity are a common clinical 
problem in pediatric otolaryngology, particularly among 
children aged 1–5 years, with an incidence as high as 
96.8% in this age group. They are slightly more common 
in females (53.4%) and occur more frequently in the right 
nasal cavity (74.1%). The majority of  nasal FBs include 
organic materials such as seeds (32.1%) and synthetic 
items such as plastic beads, polyurethane foam, stones, 
and erasers.
In most cases, FBs are inserted under parental observation 
and removed promptly. Complications are therefore 
minimal. However, in cases where the event is unwitnessed, 
the FB may remain undetected, leading to variable 
complications including persistent nasal discharge, foul 
odor, epistaxis, or nasal obstruction. Rarely, long-standing 
FBs can elicit chronic inflammatory changes, resulting in 
nasal polyposis or mimicking sinus tumors.
This report describes a case of  a pediatric nasal FB that 
presented unusually as unilateral nasal polyposis and 
chronic sinusitis, emphasizing the diagnostic challenges 
and the importance of  vigilance in unilateral sinonasal 
disease.

Case Description
We present a case of  a 6-year-old girl. She had a year-long 
history of  progressive right nasal blockage and right nasal 
discharge. She occasionally complained of  right-sided 
facial pain. There was no reported or witnessed history 
of  FB insertion. She was given some medications earlier, 

without improvement. Anterior rhinoscopy revealed 
reduced patency of  the right nasal cavity, nasal discharge, 
and nasal polyps filling the right nasal cavity. Computed 
Tomography (CT) scan revealed opacification of  the 
right nasal cavity and maxillary antrum.

Figure 1: CT scan showing opacification of  the right 
nasal cavity and maxillary antrum

The patient was booked for Functional Endoscopic Sinus 
Surgery (FESS). Intraoperatively, extensive multiple nasal 
polyps were found. These arose from both the septum and 
the lateral wall. On removing the most anterior polyps, 
an FB was incidentally discovered in the middle meatus. 
It was embedded within the nasal polyps and removed. 
The polyps in the nasal cavity and maxillary antrum 
were removed and sent for histological examination. The 



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Am. J. Med. Sci. Innov. 4(2) 111-113, 2025

Figure 2: Showing nasal polyp and FB embedded deep 
within the nasal cavity

Figure 3: Multiple polyps removed

Figure 4: FB (large piece of  rubber) removed

patient was reviewed 24 hours postoperatively. The nasal 
pack was removed, and she was discharged. She was seen 
in the outpatient clinic at 2 and 4 weeks postoperatively 
and had complete symptom resolution. Histology 
revealed an inflammatory polyp.

Discussion
Foreign bodies in the nasal cavities are common incidents 
in children, the various clinical presentations are history 

of  insertion of  foreign bodies in 85.8% and 14.2% with 
no history of  insertion, mucopurulent nasal discharge 
51.7%, foul nasal odour 9.4%, epistaxis 5.7%, nasal 
obstruction and mouth breathing 2.8% and 1.9% cases 
respectively1. This is similar to a case we presented 
as there was no history of  FB given by the patient or 
witnessed by any third party. The duration of  symptoms 
ranges from an hour to 4 years with 69.8% presenting 
within 24 hours and 25.5% presenting after 24 hours. 
Diagnosis is often made with anterior rhinoscopy, but 
sometimes nasal fibroendoscopy and imaging may be 
useful. The majority of  nasal foreign bodies (99.1%) 
located were in the antero-inferior portion of  the nasal 
cavities and could be removed with simple instruments. 
Extraction was performed in consultation room in 84.5% 
of  cases and in the operating room in 15.5% of  the cases1. 
Most of  the foreign bodies are inert and do not cause any 
local tissue reaction but some of  these can cause serious 
complications. Nasal FB in accordance with the literature 
leads to complications in 9.05% of  the cases, epistaxis 
17.24%, nasal infections 13.6% and purulent maxillary 
sinusitis in 1.9%1. Cases of  nasal FB slipping into the 
alimentary canal were also reported.
The histological study included the standard sample 
processing followed by paraffin embedding of  the 
material and staining of  the micropreparations with 
hematoxylin and eosin. It was shown FB in the nasal 
cavity or maxillary sinus can cause marked structural 
reorganization of  the mucous membrane usually with the 
predominance of  hypertrophic and polypous changes8.

CONCLUSION
Undoubtedly, unwitnessed and unrecognized nasal 
FB could prove difficult for clinicians to diagnose. 
Clinicians should recognize the underlying causes that 
are responsible for the symptoms of  chronic sinusitis 
especially in children, and a unilateral nasal discharge 
should be assumed to be caused by an intra-nasal foreign 
body until proven otherwise.

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