Goals

To remove a well-visualized foreign body from the external ear canal, relieve pain, and prevent infection.

Background

The ear is composed of external, middle, and inner components. A foreign body of the ear refers to organic (e.g., food particles, cotton pieces, insects) and inorganic (e.g., beads, rocks, toys) materials inserted into the external ear canal. Children older than 9 months of age often present with foreign bodies in the ear as this is the age that the pincer grasp is developed and tiny objects can be maneuvered and inserted in the ear canal. Foreign body removal from the ear can be done by irrigation, mechanical extraction, or suction. The most common complication of foreign body removal from the ear is an abrasion or laceration to the external ear canal; the risk increases with multiple attempts at removal.

Contraindications

Referral to a otolaryngologist is warranted in the following situations:

• TM perforation or unable to visualize TM
• If the foreign body is a battery of any type (due to risk of time-sensitive liquefaction necrosis)
• Removal of foreign body not likely on first attempt
• Inadequate resources to manage an uncooperative patient