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A healthy 15-year-old male patient presented with several years of bilateral congestion and hyposmia. He and his family denied facial trauma, recent or recurrent sinusitis, rhinorrhea, difficulty breathing, pain, change in vision, and constitutional symptoms. He had never had allergy testing but did have occasional allergic symptoms, including sneezing and itchy eyes and nose. He did not report any drug, alcohol, or tobacco use. He was developmentally normal. On physical examination, the patient appeared healthy and had a normal-sounding voice. The tonsils were small, without crypts or tonsilloliths, and there were no neck masses.
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D. Foreign body
The results of the computed tomography scan showed clear sinuses, but a 9-mm spherical structure was noted in the left inferior nasal cavity with surrounding spiculated calcifications and chronic dystrophic calcification, suggestive of an intranasal foreign body.
The patient was taken to the operating room for a bilateral nasal endoscopy, turbinate reduction, and removal of a foreign body from the left nasal cavity. The inferior turbinate was medialized, and there was friable granulation tissue inferomedial to the inferior turbinate. This tissue was gently suctioned, and bleeding was encountered. After continued suctioning and application of a topical decongestant with an oxymetazoline-soaked pledget, a metallic foreign body was visualized (Figure 2). This body was removed and epistaxis was controlled.
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Corresponding Author: Dylan Z. Erwin, BBA, 7342 Oak Manor Dr, #7206, San Antonio, TX 78229 (email@example.com).
Published Online: February 18, 2021. doi:10.1001/jamaoto.2020.5628
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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