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