Foreign Body Removal from Ear

14 Aug

•In one retrospective review of 191 aural foreign bodies in children, beads, pebbles, and plastic toys were most common in young children, insects in older children

Irrigation, suction, and instrumentation were all attempted. 30% required surgical removal under anesthesia, and most of these were in children under 8 years old

For irrigation, use a 60cc syringe with a 16g angiocath and body temperature water. Do NOT irrigate disc batteries or objects that may swell (beans, peas)

Objects with sharp edges should be removed with an operating microscope or in the OR

Insects can be killed with microscope immersion oil, mineral oil, or lidocaine, then extracted by irrigation or instrumentation. Microscopic exam is required after removal to r/o retained insect parts

Smooth round objects are very difficult to extract. Try suction

•Complications: EAC lacerations or abrasions, TM perforation, iatrogenic otitis externa

Give antibiotic drops to anyone with inflamed or lacerated EAC after FB removal

•Suggested indications for ENT consultation/referral:
  • –Lack of proper instrumentation
  • –Lack of staff to adequately restrain uncooperative child
  • –Failure to remove foreign body on initial attempt(s)
  • –Existent injury to the external auditory canal or tympanic membrane
  • –Object wedged in the medial external auditory canal or up against tympanic membrane
  • –Glass or other sharp-edged foreign body
  • –Special circumstances such as insects, putty, and disc batteries

Submitted by M. Smith.

Reference(s): Ansley JF, Cunningham MJ. Treatment of aural foreign bodies in children. Pediatrics. 1998 Apr; 101(4 Pt 1):638-41.; picture

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