Foreign Body Removal, Ear
The removal of foreign bodies from the ear is a common procedure in the emergency department. Children older than 9 months often present with foreign bodies in the ear; at this age, the pincer grasp is fully developed, which enables children to maneuver tiny objects.
In adults, insects (eg, cockroaches, moths, flies, household ants) are the foreign bodies most commonly found in the ear. Rarely, other objects have been reported (eg, teeth, hardened concrete sediments, illicit drugs, plant material).1,2,3 Some persons from Mexico and Central America reportedly insert leaves and other plant material into their ears as a form of native remedy.4 Also, some adults with psychiatric disorders present to the emergency department with foreign bodies lodged in their ears as a form of self-mutilation called ear stuffing.5
In children, the range of foreign bodies is extensive. Food particles (eg, candy, vegetable matter, beans, chewing gum) and other organic material (eg, leaves, flowers, cotton pieces) are commonly encountered. Inorganic objects such as small toys, beads, pencil erasers, and rocks are also common.
The prompt removal of foreign bodies from the ear is indicated whenever a well-visualized foreign body is identified in the external auditory canal and an uncomplicated first attempt is anticipated.
The presence of a tympanic membrane (TM) perforation, contact of a foreign body with the tympanic membrane, or incomplete visualization of the auditory canal are indications for urgent-emergent ENT consultation for removal by operative microscope and speculum.
If button batteries or hearing aid batteries are involved, emergent ENT consultation is always warranted because time-sensitive liquefaction necrosis may lead to subsequent tympanic membrane perforation and further complications. In fact, irrigation should never be attempted in such cases, as it accelerates the necrotic process.6,7