Prolonged Undiagnosed Nasal Foreign Body Case Report.

The case report presented is a 22-year-old female with an undiagnosed nasal foreign body (NFB) in her right nasal cavity for 18 years. Previous physical examination and anterior rhinoscopy by other health care specialists failed to detect the NFB. She was treated conservatively by many ENT specialists as sinusitis with antibiotics therapy and anti-allergy drugs for many years with no improvement. Due to persistent sinus symptoms unrelieved by conservative treatment further investigation with a paranasal sinus computed tomography (CT) scan was completed that identified the NFB. The NFB was successfully removed surgically with the aid of nasal endoscopy under general anesthesia. The NFB was diagnosed as a piece of calcified externally cotton vegetation. This case highlighted the importance of complete investigation of persistent symptoms including imaging with a non-contrast spiral CT, in addition to a dilated physical examination, clinical and pathologic lab exam.