FOREIGN BODY IN THE EAR

Causes

Common foreign bodies (FB) include:

  • Insects (flies, cockroaches, ants), seeds, beads, stones
  • Children: Usually insert the FB themselves, or their peers may do it
  • Adults: Usually insects, cotton buds
  • Occasionally the FB may penetrate adjacent parts and lodge in the middle ear

Clinical features

  • Blockage, FB may be seen
  • Noise in the ear if it is a live FB like an insect
  • Hearing loss

If attempts have been made to remove the FB:

  • Bleeding/discharge from the ear

MANAGEMENT

Smooth round FBs

  • Syringe the ear with clean lukewarm water
  • If FB cannot be removed by syringing, remove with a foreign body hook
    • General anaesthesia may be essential in children and sensitive adults
    • Do NOT use forceps to try to grasp round objects, as this will only push them further in the ear

Other FBs

  • If there is an edge to grab, remove with Hartmann (crocodile) forceps

Insects

  • Kill these by inserting clean cooking oil or water into the ear, then syringe out with warm water
  • Cockroaches are better removed by a crocodile forcep since they have hooks on their legs that
    make removal by syringing impossible

Impacted seeds

  • Do NOT use syringing with water as the seed may swell and block the ear
    • Refer immediately to ENT specialist if you cannot remove with a hook
  • Suction may be useful for certain FBs