Foreign body of ear

Foreign Bodies of Ear

1. Non-Living Foreign Bodies

Common Types:
  • Children: Paper, sponge, seeds (rice, wheat, maize), slate pencil, chalk, metallic ball bearings.
  • Adults: Broken matchstick, overlooked cotton swab.

Vegetable Foreign Bodies:
Tend to swell up with time (absorb moisture) → get tightly impacted → may suppurate.

Methods of Removal

Method Indication
Fine Crocodile Forceps Soft and irregular objects (Paper, swab, sponge).
Syringing Seed grains and smooth objects.
Microscopic Removal Impacted bodies or after failed attempts. (Preferably under GA).
Postaural Approach Deeply impacted bodies (medial to isthmus) or pushed into middle ear.
⚠ CRITICAL WARNING:
Smooth and hard objects (e.g., Steel Ball Bearings) should NOT be grasped with forceps. They tend to slip and move inwards, potentially injuring the Tympanic Membrane or ossicles.

2. Living Foreign Bodies

A. Insects

Types: Mosquitoes, beetles, cockroaches, ants.
Symptoms: Intense irritation and pain.

Step 1: DO NOT catch alive
↓
Step 2: Kill the insect (Oil, Spirit, Chloroform water)
↓
Step 3: Remove (Forceps/Syringing/Suction)

B. Maggots (Myiasis)

  • Aetiology: Flies attracted to foul-smelling ear discharge lay eggs → hatch into larvae.
  • Season: August, September, October.
  • Symptoms: Severe pain, swelling around ear, blood-stained watery discharge.
Treatment of Maggots:
  1. Instill Chloroform water to kill maggots.
  2. Remove with forceps.
  3. Note: Syringing is usually NOT advisable as TM perforation is often present.

Complications of Unskilled Removal

  • Laceration of meatal lining.
  • Damage to Tympanic Membrane.
  • Dislocation/Damage to Ear Ossicles.
📚 Source: ENT Dhingra | Chapter 8

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