1. Foreign bodies in the ear
Clinical picture;
Children may present asymptomatically or pain or discharge caused by otitis externa.
Adult are seen with cotton wool or broken matichsticks which has been used to clean or scratch the
ear canal, Cockroaches live insects are annoying due to discomfort created by loud noise &
movement.
Prior to removal ,it may be useful to consider three aspects of the situation;
1)The nature of the foreign body.
2) The precise location of the foreign body.
3) Patient considerations.
The nature of the foreign body
Living insects should first be killed by instilling oil into the meatus before removal.
Irregular/soft graspable non-living object(dead insects,cotton wool, paper, small toy) may be
removed with a crocodile forceps.
Organic objects (beans etc) which absorbed water ,swell & cause pain, should not be syringed.
Round ,hard ,smooth, non-graspable should be removed with foreign body hook or syringing under
G/A.
Button batteries should not be syringed as they may leak on exposure to water. They should be
removed urgently.
Location of the foreign body
Lateral lying foreign body easier access ,wider diameter , elastic nature, &lesser sensitivity of the
lateral canal make the removal of foreign bodies easier.
Foreign body impacted medial to isthmus, when failed,removal attempts have caused trauma &
swelling of the canal skin may required surgical removal. A post-auricular approach & widening of
the canal by bone drilling is advised.
Patient considerations
Younger uncooperative children require special handling,Time spent gaining the child’s confidence is
a worthwhile investment. Syringing is often useful &better tolerated & risk of trauma is low.
Once the foreign body is removed,it is advisable to check the ears for the underlying pathology, as
the child may have put the foreign body due to itch ,pain,otorrhoea.

2. Complications
Laceration of the ear canal
Perforation of TM
Ossicular chain dislocation
Facial nerve palsy may occur secondary to leakage of alkaline matter from the button battery &
necrosis of the surrounding tissue.