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2 phase

Bad Breath (halitosis) Research


Foreign bodies

I remember that at the age of about 3, my brother developed a horrific smell that enveloped his entire body. It turned out that the smell came from his having stuffed paper tissue up his nose...

A common pastime of little children is sticking things up their nose. Luckily, most common household items don't fit into the nostrils of a small child, but then again, some do - pieces of paper, peas, beans, seeds, pencil erasers are just some examples. If the material stuck up the nose absorbs water, it quickly becomes full of bacteria and their stinky metabolic products. Any child presenting with an offensive smell should have his nostrils examined immediately. Unfortunately, many doctors are not aware of this. This is complicated by the fact that with time, the smell appears to be coming from the entire body. This led some doctors to report (erroneously, I think) that the smelly molecules were originating in the nose, but subsequently got into the bloodstream and coming out of pores in the skin.

If the "foreign body" up the nose does not absorb water, it may not smell for many months. With time, the foreign body may become coated with calcified material. It may impede the proper flow of air through the nostrils, cause a low grade infection, and lead to an odor which may not be overwhelming.

In 1991 we had an interesting case of a 28 year old who complained of bad breath. She had three different kinds of odor. One was a slight oral odor. The second was cigarette odor. The third was a slight, but
mouthoff.gif (4050 bytes)noticeable, peculiar odor from the nose itself. This prompted me to send her to an outstanding ear-nose-throat specialist, the department head in a major hospital outside of Tel Aviv area. He found the presence of a "foreign body" up her nose (When I asked him later, "how come you found it when other ENT specialists didn't", his laconic reply was "I looked for it"). The foreign body was covered with calcified material, and had to be removed under anesthesia at the hospital. The foreign body turned out to be a child's bead, probably left up her nose some twenty-five years earlier. Probably, because it was plastic, it didn't smell for years. Interestingly, although the smell was slight, she complained of fierce odor, and was very upset that others, especially doctors, had trouble noticing it. Perhaps, since it was lodged in her nose, the concentration that she smelled was much higher than was smelled by others when she exhaled.

Following this story, I went back to read a few articles on odor resulting from nasal foreign bodies. Thus, when I received a call from a mother in November, 1992, I had a feeling that a similar issue was involved. The mother told me that her son, 19 years old and severely
Halitose retarded, had suffered for the previous two months, from a terrible odor all over his body. As a result, he had been expelled from his special boarding home, and taken to a variety of specialists including a dermatologist, allergologist. He had been put on a special diet and had lost considerable weight. He had also spent an entire morning at a major hospital, including consolation with the ear-nose-throat department.

Upon seeing the patient, it was immediately obvious that one of his nostrils was red and running. The vile odor which enveloped him was
Halitosisdefinitely nasal in its character. I asked his mother whether she didn't suspect his nose as the source.
"Yes", she answered, "actually one of my neighbors suggested that it might be, but we did spend that day at the hospital, and they took an x-ray of his nasal passages and didn't find anything." I asked her whether anybody looked up his nose.
"No", she answered, "the doctor just looked at the x-ray".

The smell was awful, and I tried to figure out whether it was coming from his nose or whole body. The smell was strongest from his nose, but it was also strong coming from his hands, hair and clothes. On the other hand, I did not detect odor coming from his back nor his ankles. Clearly, the boy was taking the discharge from his nose and spreading it to certain parts of his body. This could explain the impression that this kind of odor appears to emanate from the entire body.

The next day the boy was sent to another ear-nose-throat specialist who removed a huge, blackened piece of unbelievably foul-smelling paper tissue from his nose. The symptoms disappeared immediately, and the last I heard, the family was happily back to their routine. Visit Dr. Rosenberg's new website on smells