A teenager smelled foul odours for years only to find a strange object stuck in his nose

This teenager suffered from nasal congestion for several years, with a reduced sense of smell. That is, until he blew his nose, at which point a mysterious and unpleasant foul odour filled his nostrils. It turned out that an air pistol pellet (BB) had been lodged there since he was eight years old, his doctors reported in the journal JAMA Otolaryngology - Head & Neck Surgery on February 18, 2021.

Since he was 8 years old

In fact, when the 15-year-old patient was first examined, healthcare professionals first observed through an endoscope, 'turbinate hypertrophy,' that is, a widening of these three narrow passages in the nose. A condition sometimes caused by seasonal allergies or inflammation of the sinuses. He was prescribed a nasal spray and antihistamines.

But a year later, the teenager returned with the same symptoms. And when he blows his nose in front of his doctors, 'a pungent, foul odour [pervades] the room,' the authors describe in the report. A CT scan finally revealed a 9-millimeter foreign body in his nasal cavity. A surgical intervention made it possible to dislodge the spherical object, a metal ball from a propulsion pistol.

And indeed, he had got hit with one of those pellets in the nose when he was about 8 years old. Because he had shown no concerning signs, his parents hadn't worried over-much. A foreign body trapped for such a long period could nevertheless have caused complications, such as an infection spreading to the jaw or eyes, damage to nearby bones in the nose, or even inhalation of the object, which would have could descend to the bottom of the throat.

Well hidden within the patient's nose

As for its only symptom, the presence of an horrendous odour, it is explained by the 'blockage of the natural drainage pathways in the nose,' explains Dylan Z. Erwin, co-author of the report and medical student at the University of Texas at San Antonio (United States). 'So there is a buildup of mucus, inhaled debris and bacteria.' A blockage that does not always manifest with a fever, making the diagnosis difficult.

Especially since in the case of the teenager, the lead had lodged tightly in the lower turbinate of his nose and new healthy-looking tissue had covered it, completely concealing it from the sight of the doctors. Fortunately, all's well that ends well. The young patient did not develop any complications. After the operation, his nasal tissues returned to normal. And its olfactory bulbs, more pleasant smells.