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Foreign bodies in the ear
- 1. FOREIGN BODIES IN THE EAR Prepared by, Mrs Nimi Elizabeth Mathew Lecturer, LLCON
- 2. THE FOREIGN BODIES ARE OF 2 TYPES: 1. Living : Insects, maggots 2. Non- living a) Hygroscopic: peas,wheat b) Non-hygroscopic : stones,plastic pieces, broken end of match stick
- 4. CLINICAL FEATURES • Ear pain • Decreased hearing • Sense of fullness in the ear • Throbbing sensation • Itching
- 5. CONTRAINDICATIONS OF FOREIGN BODY REMOVAL • Uncooperative patient • suspectedTM perforation • Removal of organic material or removal of a battery.
- 6. TREATMENT
- 7. MANUAL INSTRUMENTATION (E.G., FORCEPS, CURETTES, ANGLE HOOK) • These are ideally used in conjunction with the operating head of an otoscope, but can also be used with the diagnostic head. • The pinna should be retracted, and the foreign body visualized. • When using forceps, the foreign body can be grasped and removed. Both curettes and right angle hooks should be gently maneuvered behind the foreign body and rotated so the end is behind the foreign body, which can then be pulled out.
- 9. IRRIGATION • This can be performed with either an angiocatheter or section of tubing from a butterfly syringe. Using body temperature water, retract the pinna, and squirt water superiorly in the external auditory canal, behind the foreign body which will then be washed out of the canal.
- 13. SUCTION • This should be performed with a soft suction tipped catheter that has a thumb controlled release valve. • Insert the suction against the foreign body under direct visualization and then activate the suctions and remove the foreign body. • Maintaining suction until the foreign body is completely out of the external auditory canal.
- 15. • Living foreign body is examinated first by instilling oil or water in the ear to suffocate the insect. • Hygroscopic foreign bodies may be shrunk by using glycerine or absolute alcohol drops.
- 16. GENERAL ANAESTHESIA: • It should be given for removing the foreign body, if the child is uncooperative, or if the foreign body is impacted. This is preferably done under microscopy.
- 17. • Antibiotics : • Control the infection and edema.This may be helpful while removing the foreign body. • Postaural or endaural incision • An incision parallel and a few millimetres posterior to the retroauricular fold, made to gain access to the mastoid cortex. • It is rarely required. • Only used in case of severely impacted foreign body.
- 20. COMPLICATIONS • Injury to the tympanic membrane, ossicles, and even labyrinth • Otitis externa • Otitis media • Lodgement of the foreign body in the middle ear.