Ear FB

1. FOREIGN
BODIES IN
EAR AND
KERATOSIS
OBTURANSDr Somnath Saha

2. Foreign
bodies in
ear

3. Foreign
bodies in
the ear
• Classification
– Living
– Non-living
• Common site of impaction:Medial to isthmus

4. Examples of
non-living
foreign
bodies
• Papers
• Pencils
• Pieces of chalk
• Metallic ball bearings
• Vegetable foreign bodies:Tend to swell up with time
and get tightly impacted or even suppurate

5. Living
foreign
bodies
• Flying or crawling insects like mosquitoes,etc can enter
the ear canal and cause intense irritation
• They should not be extracted alive
• They should be killed by instilling chloroform water in
the ear canal or oil(household remedy) first

6. Methods of
removal of
foreign
bodies

7. Methods of
removing
foreign
bodies
• Forceps removal
• Syringing(not advisable in case of maggots in ear)
• Suction
• Removal under microscope with special instruments
• Postaural approach

8. Keratosis
obturans
• Definition
– Collection of a pearly white mass of desquamated cells in
the external acoustic meatus

10. Etiology
and
pathology
• Age group affected:5-20 years most commonly
• Associated with:Bronchiectasis/chronic sinusitis
• Possible cause:Failure of migration of surface
epithelium from surface of tympanic membrane to
posterior meatal wall

11. Clinical
features
• Symptoms
– Pain in ear
– Deafness
– Occasional tinnitus
– Ear discharge occasionally
• On examination
– Pearly white keratinous material deposited in multiple
layers found
– Removal may show widening of meatus/granuloma
formation

12. Treatment • Syringing and instrumentation for removal of the mass
• Secondary otitis externa should be looked for and
treated if present