Child Put Something in Their Nose or Ear: A Parent’s Guide for London & Essex It can happen in seconds. A toddler is playing with beads, a small toy, a pea, a piece of tissue, a rubber, a seed, a button battery or a magnet. Suddenly, they say something feels funny — or you notice a blocked nostril, ear discomfort, crying, discharge or a bad smell. For many parents, the first instinct is to try to pull it out. That is understandable, but it can sometimes make things worse. If your child has something stuck firmly in their nose or ear, it is usually safer not to poke around at home. Attempts with tweezers, cotton buds, hair clips or fingers may push the object deeper, cause bleeding, damage the ear canal or make removal more difficult. Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children with ear, nose and throat concerns from London, East London, Brentwood, Romford, Ilford, Redbridge, Chelmsford and wider Essex. This guide explains what parents should do, what to avoid,...
When it comes to patients complaining of bad breath (halitosis), it's crucial to distinguish between objective halitosis and subjective complaints. Relying solely on patients' self-assessments of their condition can be unreliable. Here's why we need to take a more comprehensive approach:
👃 Subjective vs.
Objective Halitosis: Simply asking patients if they believe they have halitosis
may not be enough. Some may have subjective complaints, which means they
perceive bad breath when it may not be present. Treating these patients for
odour elimination can be ineffective and ethically concerning.
👩⚕️ Confirming Tonsillar
Aetiology: If tonsillar issues are suspected as the cause of halitosis, it's
essential to confirm this reliably. Standard therapies like tongue scraping can
help rule out oral halitosis.
🏥 Medical vs. Surgical
Approach: Before considering surgical options, it's advisable to attempt
medical resolution. Surgical interventions may have comparable efficacy, but
robust evidence is still lacking. Complete removal of the crypt system is
theoretically favourable, although cryptolysis, a less invasive procedure, can
also be efficacious.
👶 Adults vs. Children:
Tonsillar surgical procedures for halitosis are more commonly performed in
adults, as the tonsils become less biologically significant with age. However,
the risks of tonsillectomy are relatively higher in adults.
🌡️ Post-Operative
Considerations: It's important to note that halitosis can worsen initially
after surgical interventions due to post-tonsillectomy eschar. This temporary
condition can last for about two weeks, with some parameters changing up to 4
weeks postoperatively.
The choice between medical and surgical approaches should be
based on individual factors, including the patient's age, halitosis severity,
and preference. It's essential to weigh the risks, benefits, and total
treatment costs, including recovery time. Discussion with a healthcare
professional is crucial in making an informed decision. If you have any
questions or experiences, please drop them in the comments below. 🗨️💪
Classification of Halitosis
Type 0: physiologic | The physiologic odour is present in all healthy individuals. It is formed by the physiologic contributions from the following types. The levels of physiologic halitosis fluctuate but stay under halitometric limits and do not disturb the patient's social environment. No treatment is needed beyond reassurance. |
Type 1: oral | Odour in association with an oral pathology, for example, tongue coating, periodontitis, xerostomia, and plaque stagnation. |
Type 2: airway | Odour in association with respiratory tract pathologies, from the nasal cavity to alveoli, for example, rhinosinusitis, laryngitis, bronchiectasis, and carcinomas. |
Type 3: gastro-esophageal | Odour in association with gastroesophageal pathology, for example, erosive gastro-oesophagal reflux disorder, gastritis with H. pylori infection, Zenker diverticulum, and gastrocolic fistula. |
Type 4: blood-borne | During gas exchange, odorant volatiles from the systemic circulation are transferred to the exhaled breath. Hepatic, renal, digestive, and endocrine system disease, including trimethylaminuria. |
Type 5: subjective | The patient believes there is halitosis, but no odour is detectable clinically, for example, retronasal olfaction, psychologic (olfactory reference syndrome), and neurologic conditions (e.g., chemosensory dysfunction). |
Mr Gaurav Kumar
Ear, Nose & Throat Consultant
Consulting at Spire London East, Spire Hartswood Brentwood,
Nuffield Health Brentwood
To book an appointment, visit
https://tinyurl.com/GKAppointmentBooking
Phone Number: 07494914140
Disclaimer: For general information only, always seek
medical advice from your treating consultant.
Read more about ENT Conditions at
https://www.entsurgeon-london.co.uk
