II. Causes

  1. Insects
  2. Plastic toys or beads
  3. Cotton, paper
  4. Organic material such as popcorn kernals or vegetable material
    1. Higher risk of infection
  5. Small batteries (may be caustic!, especially button batteries)
    1. Require removal without delay

III. Symptoms

IV. Precautions

  1. Removal risks Tympanic Membrane injury
  2. First attempts at removal are most likely to succeed
    1. Best succes is for graspable objects (e.g. paper)
  3. Risk of ear canal injury and further impaction of foreign body increases with repeat attempt

V. Management

  1. Kill any live Insects before attempting removal
    1. Rubbing Alcohol or
    2. Lidocaine 2% or
    3. Mineral Oil
  2. Use otoscope with operative head
  3. Instruments and Methods
    1. Micro Alligator Forceps: Remove graspable foreign body
    2. Cerumen curettes
    3. Suction catheter
      1. Exercise caution due to risk of Tympanic Membrane Rupture and ossicle damage
      2. Typically defer Ear Suction to otolaryngology
    4. Ear Irrigation
      1. Do not use if organic foreign body or button battery
    5. Katz Extractor
      1. http://www.inhealth.com/category_s/49.htm
    6. Tissue Adhesive technique
      1. Indicated for dry, hard, non-organic foreign bodies
      2. Apply a drop of Tissue Adhesive to the wooden end of a cotton applicator (e.g. similar to q-tip)
      3. Under direct visualization, apply the freshly glued, wooden tip to the foreign body
      4. Hold the applicator tip against the surface of the foreign body for 30 seconds
      5. Carefully withdraw both the applicator and the foreign body as a unit from the ear canal
      6. Lin in Herbert (2015) EM:Rap 15(2): 6-7
  4. Other measures
    1. Acetone dissolves styrofoam and super glue
    2. Otic antibiotic drops indicated for concurrent Otitis Externa or ear canal Trauma

VI. Management: Referral

  1. Most foreign bodies may be safely deferred to ENT for removal in 1-2 days
    1. Batteries (esp. button batteries) and magnets should be removed as soon as possible (local necrosis risk)
  2. Referral Indications
    1. Young or developmentally delayed patients requiring Conscious Sedation
    2. Ear canal Lacerations, Tympanic Membrane injury or other Trauma on attempted removal
    3. Foreign body refractory to removal attempts (e.g. impacted in canal)
    4. Sharp foreign body

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Ontology: Foreign body in auditory canal (C0161007)

Concepts Injury or Poisoning (T037)
ICD9 931
ICD10 T16
SnomedCT 157552003, 211623003, 75441006, 32874004
English Foreign body in ear NOS, FB-For body EAC-ext aud can, Foreign body in EAC, foreign body in external ear canal, foreign body in external auditory canal (physical finding), foreign body in external auditory canal, foreign body of ear (diagnosis), foreign body of ear, external auditory canal foreign body, Foreign body retained in ear, foreign body ear, Foreign body (in);ear, foreign body in ear, body ear foreign, bodies ear foreign, ear foreign body, foreign body in auditory canal, Foreign body in ear NOS (disorder), Foreign body in ear, Foreign body in auditory canal, FB - Foreign body in EAC - external auditory canal, Foreign body in external auditory canal, Foreign body in auditory canal (disorder), Foreign body in ear (disorder), auditory canal; foreign body, ear; foreign body, foreign body; auditory canal, foreign body; ear
Korean 귀의 이물
Spanish Cuerpo extraño retenido en el oído, Cuerpo extraño en oído, cuerpo extraño en oído, SAI, cuerpo extraño en oído, SAI (trastorno), cuerpo extraño en el conducto auditivo (trastorno), cuerpo extraño en el conducto auditivo, cuerpo extraño en el oído (trastorno), cuerpo extraño en el oído
Portuguese Corpo estranho no ouvido, Corpo estranho retido no ouvido
Italian Corpo estraneo ritenuto nell'orecchio, Corpo estraneo nell'orecchio
German Fremdkoerper im Ohr
French Corps étranger dans l'oreille, Corps étranger du conduit auditif externe
Czech Cizí těleso v uchu, Cizí těleso uvízlé v zevním zvukovodu
Dutch vreemd lichaam in oor, vreemd lichaam achtergebleven in oor, Corpus alienum in oor, corpus alienum; gehoorgang, corpus alienum; oor, gehoorgang; corpus alienum, oor; corpus alienum
Japanese ジナイイブツ, 耳内異物
Hungarian Idegentest a fülben, Retineált idegentest a fülben