Recently the network has gone viral a propaganda post about cassia sandpit, the post is mainly to warn parents to pay attention to protect their children from cassia and prevent the occurrence of cassia foreign bodies in the ear and nose. So what exactly does it matter if cassia enters the ear or nose? What are the consequences? What should we do if it happens? First of all, let’s take a look at the things that children put into their ears and nose. The most common foreign objects in the ear and nose are toys and small accessories from everyday objects, such as paper balls, beads, rubber, plastic toys, buttons, etc. Next are plant-based foreign bodies, including beans, melon shells, fruit rinds, kernels, and various types of seeds (such as cassia seeds). There are also insects, such as small cockroaches, small flying insects, etc. The majority of foreign bodies in the throat are animal bones such as fish bones, chicken bones, shrimp and crab shells; plant-based foreign bodies such as peanut and melon shells, date skins, bamboo sticks, etc. A small number of small toy accessories or other small parts can also be seen. There is a special foreign body, that is, button battery, this foreign body is very harmful to the local tissue. How can parents detect foreign bodies in the ear, nose and throat? Different foreign bodies enter the ear canal and behave differently. A foreign body that does not change its shape when exposed to water may stay in the external ear canal without symptoms, or it may cause discomfort when it irritates the external ear canal, and the child will not complain about it, often scratching the affected ear with his or her hand and crying if the infection causes pain. Foreign bodies that change shape when exposed to water and stay in the external ear canal, such as seeds of plants, swell in size when exposed to water and cause swelling and pain or infection in the affected ear very quickly. Insect-like foreign bodies crawling and scratching in the outer ear canal can cause severe ear pain and make the child panic. Some foreign bodies remain in the external ear canal and parents are unaware of them until they come to the doctor due to infection and pus; some are encased in cerumen and form cerumen embolisms. When foreign bodies in the ear canal are not treated in time or are not treated properly, they can cause otitis externa, tympanitis, and tympanic membrane perforation, which can affect hearing in serious cases. Nasal foreign bodies are mostly due to children’s curiosity, and foreign bodies such as paper rolls, cotton balls, plastic toys, buttons, beans, and melon shells are inserted into the nasal cavity when playing, which can cause purulent and bloody secretions in the nasal cavity over time. Nasal odor and stench are the most common symptoms of nasal foreign bodies in children. Parents often find that their children have unilateral nose odor that does not subside over time, so once the nasal cavity has a long-term odor, foreign bodies in the nasal cavity should be highly suspected. Also common are rhinorrhea and nasal congestion, most of which are unilateral. Long-term untreated nasal foreign body can cause rhinitis, sinusitis, recurrent nasal bleeding, nasal snot reflux irritates the throat leading to repeated coughing, more permanent may cause nasolithiasis, that is, foreign body as the core, inflammatory exudate concentration, decomposition of a variety of mineral salts around this core deposition, the day expanded to form a nasolith. If a button battery is inserted into the nasal cavity, 90% of nasal mucosal erosion and nasal septal perforation will occur, which is due to the gradual liquefied necrosis of the mucosa caused by the electrolyte solution leaking from the present button battery; the corrosiveness of mercury oxide in the leaking material; the electrical burns caused by local microcurrents; and the local compression of the mucosa by the foreign body causing mucosal necrosis. In mild cases, the nasal mucosa is eroded and swollen, and in severe cases, the nasal turbinates and septal cartilage are destroyed, and symptoms of systemic toxicity such as high fever, pain and elevated blood leukocytes occur, and the severity of symptoms and prognosis are proportional to the time the foreign body stays in the body. Button battery nasal foreign body is a more dangerous type of foreign body, once found, should be treated urgently. Foreign bodies in the throat often manifest as a tingling sensation in the throat, which is aggravated when swallowing. The painful area is mostly fixed and the degree of tingling is related to the size, location and type of foreign body. The main symptom of pharyngeal foreign body is sore throat, which is aggravated by swallowing, among which continuous drooling is a symptom unique to children with foreign body in the throat. They refuse to eat despite having an appetite and cry violently when eating. Most commonly, fish spikes are stuck in the throat. Younger infants and toddlers exhibit crying, vomiting, digging with their fingers in their mouths, refusing to eat, etc. Older children can express the sensation of a fish spike stuck in the throat. The main symptom of laryngeal foreign body is dyspnea, often with hoarseness with inspiratory laryngeal tinnitus, and in severe cases, severe symptoms of cyanosis, coma, and asphyxia. This condition is more urgent and is most commonly caused by running or crying while eating jelly, large pieces of apples, or dates. For parents, there are several issues that need to be taken seriously: 1. After parents find a foreign body in the pediatric otorhinolaryngology, it is recommended that they do not try to take it out by themselves because it may cause damage to the surrounding tissues due to improper handling or the foreign body may be more difficult to remove due to displacement, so they should quickly send it to the hospital and ask a professional physician to handle it. 2, the plant foreign body, do not rinse or point medicine, because the plant foreign body can absorb water to become larger, resulting in more difficult to remove. 3.Do not give the child any more food or water when foreign body in the throat is suspected, so as not to slide the foreign body to a deeper position or cause the child to choke and cough, causing a foreign body in the airway. 4, once the foreign body in the throat obstruction, breathing difficulties, should be quickly sent to the hospital, is strictly prohibited to pat the child’s back, or shaking the child, please do not feed water, because may aggravate the breathing difficulties and lead to the occurrence of foreign bodies in the airway. 5.If the foreign body is a button battery, it should be removed as soon as possible. Even if no obvious tissue damage is found at that time after early removal, local flushing and medication should be insisted on and long-term follow-up should be conducted to reduce the occurrence of sequelae. 6, a few pharyngeal foreign body removal, such as toothpicks, glass, date nuclei, etc., damage to the pharyngeal mucosa may lead to deep tissue infection in the neck, and then develop into serious infections such as mediastinitis, which can be life-threatening. Parents should pay attention to this and stay in the hospital for observation or close follow-up. What will the doctor do when you get to the hospital? Non-circular hard foreign bodies such as paper balls, cotton balls, melon seed shells, etc. can usually be removed directly under direct vision with gun-like forceps. For round hard foreign bodies such as beans and glass beads, foreign body hooks can be used to reach the back end of the foreign body and hook it out, but it is not advisable to use gun-like forceps to clip it out, so that the foreign body will not slide to the deeper part. If the child is cooperative and the foreign body is not deep, the foreign body can be removed in the outpatient clinic, but if the child cries and does not cooperate, or if the foreign body is deep, or if the foreign body is stuck in a special position and difficult to remove, the foreign body needs to be removed in the hospital under intravenous anesthesia, that is, the foreign body is removed under general anesthesia. If the insects are superficial in the ear, they can be directly clamped out under direct vision. If the insects are deep and close to the tympanic membrane, the insects can be paralyzed by drops of dicaine surface anesthetic or soaked to death by drops of oil, and then removed by clamping the insects’ bodies with forceps under direct vision. To prevent the insects feet, wings broken left behind. Foreign bodies in the pharynx can be searched for and confirmed after spraying a surface anesthetic with dicaine, and the foreign body can be clamped out with gun-like forceps after determining its location and shape. Most of them can be successfully removed in an outpatient setting, but a small number of them may require laryngoscopic removal under general anesthesia. Most foreign bodies in the larynx need to be removed under direct laryngoscopy, or operated under emergency anesthesia without anesthesia, or admitted to the hospital for operation under intravenous anesthesia. Otorhinolaryngologic foreign bodies are common pediatric emergencies and are not usually associated with adverse consequences when properly treated. However, if not properly treated, they may result in a series of complications, such as local infection and abscess formation, secondary otitis media, rhinitis, epiglottis edema, and even life-threatening conditions. It is important to prevent foreign bodies in the ear, nose and throat. Teach children not to put tiny objects into the ear canal, nasal cavity and mouth to play with, and to add ear protection when sleeping in the wild to prevent insects from flying or crawling into the ear. When eating bony foods such as fish and chicken, chew slowly, avoid joking and playing while eating, and go to a regular hospital to have foreign bodies removed in a timely manner.