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Foreign Body in the Ear

Ear Foreign Body


Presentation

  • History, presenting symptoms and signs of patients with a clinical diagnosis of foreign body in ear , nose and throat were recorded.[medical-dictionary.thefreedictionary.com]
  • The mode of presentation, the manner of discovery and how it was managed successfully were highlighted.[ncbi.nlm.nih.gov]
  • Presentation ReelDx Pearls Diagnosis Treatment Media Patient will present as an 18-month-old with ear pain and otorrhea. Otoscopic examination reveals a small insect impacted in the ear canal which is still moving.[smartypance.com]
  • Other objects that can absorb water and swell inside the canal, such as popcorn or beans, may present with pain or ear drainage, and can present specific challenges with removal.[southlakeent.com]
  • Case Presentation: A 4-year-old girl Patient was brought to tertiary care hospital attached with medical college two day after the insertion of foreign body with complaints of severe earache, something present in the ear and history of bleeding from the[scopemed.org]
Developmental Delay
  • Management: Referral Most foreign bodies may be safely deferred to ENT for removal in 1-2 days Batteries (esp. button batteries) and magnets should be removed emergently (local necrosis risk) Referral Indications Young or developmentally delayed patients[fpnotebook.com]
  • delay Behavioral Disorder such as ADHD Mental Illness Morbidity / Mortality Complications of placement and removal of foreign body can include: Canal Laceration Pressure or liquefactive necrosis (disc batteries) Otitis Externa Tympanic membrane perforation[fprmed.com]
Camping
  • Usually this happens while sleeping on the floor or outdoors (for example, camping). This is often a frightening and dramatic event as the insect's buzzing and movement is very loud and sometimes painful.[rxlist.com]
Long Arm
  • Figure 1: C) Status post FB removal, showing long arm of malleus and capitulum of stapes still in continuity. Figure 1: D) Gross picture of FB fragments upon removal.[enttoday.org]
Skin Discoloration
  • There was no scar mark, skin discoloration, swelling, or tenderness in the pre-auricular and post-auricular region. The foreign body was embedded between the walls and did not move when attempt was made to remove it.[indianjotol.org]
Otalgia
  • […] to inflammation/infection AGE Typical age between 3 and 8 years DIFFERENTIAL DIAGNOSIS Cerumen impaction Abrasion to ear canal Otitis Externa Tumor EVALUATION History Patient may admit to placing something in ear Parents witness placement Symptoms of otalgia[urgentcarepeds.org]
  • Foreign bodies are inserted into the ear more commonly by children than adults. [3] There are other clinical features apart from otitis externa attributable to a foreign body in the external meatus such as deafness, tinnitus, and otalgia. [3] The most[indianjotol.org]
  • Acute otalgia during sleep (live insect in the ear): a case report. Agri. 2009 Jan. 21(1):36-8. [Medline]. Davies PH, Benger JR. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department.[emedicine.medscape.com]
  • Heart-shaped beads (aural foreign bodies), one removed from each of the external auditory canals of a girl, four years of age A girl, four years of age, presented with a one-week history of right-sided otalgia and otorrhoea.[racgp.org.au]
Ear Fullness
  • […] may rupture Canal erythema, swelling & foul smelling discharge may be late occurrences History Asymptomatic or incidental examination finding Pain in affected ear Noise or “drumming” in ear associated with insect foreign body Hearing loss Sensation of ear[fprmed.com]
  • In many cases, patients with foreign body in the ear are asymptomatic, and in children the foreign body is often an incidental finding, (3,4) other patients may present with pain, hearing loss, symptom of otitis media, or a sense of ear fullness.[jemds.com]
  • In many cases, patients with foreign bodies in the ear are asymptomatic, and in children the foreign body is often an incidental finding. 1 , 19 Other patients may present with pain, symptoms of otitis media, hearing loss, or a sense of ear fullness.[aafp.org]
Tinnitus
  • An unusual cause of tinnitus September 19, 2016 Po-Jun Chen, MD; Hsin-Chien Chen, MD, PhD Live insects found in the outer ear canal should be immobilized or killed before removal.[entjournal.com]
  • Foreign bodies are inserted into the ear more commonly by children than adults. [3] There are other clinical features apart from otitis externa attributable to a foreign body in the external meatus such as deafness, tinnitus, and otalgia. [3] The most[indianjotol.org]
  • Others may present with ear pain, discharge, bleeding, hearing loss or tinnitus [ 4, 5 ]. The goal of removal is to preserve the integrity of the ear while the foreign body is being removed. Removal may be done with or without general anaesthesia.[panafrican-med-journal.com]
Ear Discharge
  • Maggots: Flies are attracted to foul ear discharge and lay eggs. These eggs hatch into maggots. Maggots cause severe pain with foul discharge. Chloroform water is instilled into the ear to kill the maggots.[specialist-ent.com]
  • In rural areas of developing countries a dead housefly or maggots is commonly seen in the ears of children having ear discharge due to CSOM.[jemds.com]
Hearing Impairment
  • A patient with a penetrating foreign body who exhibits vertigo, ataxia, facial nerve damage, or hearing impairment should be urgently evaluated by an otolaryngologist.[pemcincinnati.com]
Denial
  • This denial could easily result in a delay of its discovery and increase the risk of complications. Insects are well known to crawl into the ear, usually when you are asleep.[msafe.in]
Self-Mutilation
  • Central America reportedly insert leaves and other plant material into their ears as a form of native remedy. [5] Also, some adults with psychiatric disorders present to the emergency department with foreign bodies lodged in their ears as a form of self-mutilation[emedicine.medscape.com]
Self Mutilation
  • Central America reportedly insert leaves and other plant material into their ears as a form of native remedy. [5] Also, some adults with psychiatric disorders present to the emergency department with foreign bodies lodged in their ears as a form of self-mutilation[emedicine.medscape.com]
Fussiness
  • Common symptoms of a foreign body in the ear may include ear pain, a change in hearing, drainage from the ear, fever, fussiness and increased crying (in young children), and irritability.[walgreens.com]
Dizziness
  • Follow-up A repeat exam is recommended within a week if you are experiencing no difficulties, and immediately should you experience discomfort, bleeding, drainage, dizziness, or significant hearing loss.[methodistsouthlake.com]
  • Earwax has a purpose, but it can buildup and cause problems like itching, hearing loss, dizziness, ringing in the ears, and pain.[medicinenet.com]
  • Whatever the type of object; if it has become lodged within your ear and is causing a blockage then this will cause dizziness (your balance will be affected), discomfort and a degree of hearing loss.[medic8.com]
  • If the wax impaction is causing pain, decreased hearing or dizziness, a doctor can irrigate (flush) the wax out of the ear gently with warm water and peroxide.[rxlist.com]
  • Urgent examination is indicated if the object is causing significant pain or discomfort, or there is significant hearing decline or dizziness. Exams and Tests Most objects can be seen with good lighting and a few instruments.[msafe.in]
Vertigo
  • Uncommon but potential otologic complications of ECFB removal include ossicular chain damage, sensorineural hearing loss, vertigo, facial nerve paralysis, and meningitis.[bcmj.org]
  • Vertigo Tympanic membrane perforation Facial Nerve Paralysis.[jemds.com]
  • A patient with a penetrating foreign body who exhibits vertigo, ataxia, facial nerve damage, or hearing impairment should be urgently evaluated by an otolaryngologist.[pemcincinnati.com]
  • An intact TM should be confirmed by pneumatoscopy beforehand, and the irrigation solution warmed to body temperature to prevent vertigo.[racgp.org.au]
Hyperactivity
  • A study by Celenk et al suggested that children with attention deficit hyperactivity disorder (ADHD) may be more inclined than other children to self-insert foreign bodies into the nose and ears.[emedicine.medscape.com]

Workup

  • […] from children spending more time indoors on rainy days, with greater opportunity to put a small toy in their ear or nose. [6] Differential Diagnosis Abrasions to ear canal Cerumen impaction Hematoma Otitis externa Tumor Tympanic membrane perforation Workup[emedicine.medscape.com]

Treatment

  • Medical treatment of Foreign Body in the Ear The necessity to see a medical professional depends on the object’s location and its nature.[methodistsouthlake.com]
  • Treatment of Aural Foreign Bodies in Children. Pediatrics 1998;101(4):638-640 2.Fritz S, Kelen GD Foreign Bodies of the External Auditory Canal.[urgentcarepeds.org]
  • This study is to determine the prevalence, treatment outcome and complication of foreign body injury to the ear, nose and throat in children.[ncbi.nlm.nih.gov]
  • […] foreign body Diagnostic testing: Otoscopi visualization Laboratory evaluation Not needed Differential Diagnosis Tumor or mass Cerumen Otomycosis and exostosis may be some considerations Congenital Cholesteatoma Acute otitis media Therapeutics Acute Treatment[fprmed.com]
  • What is the treatment for removal of a foreign body from the eye or ear? Visit Healthcare Clinic at select Walgreens for evaluation of the severity of the foreign body in your eye or ear.[walgreens.com]

Prognosis

  • […] instructions should include: Anticipatory Guidance Analgesics as necessary PMD follow up in 2-3 days to asses for healing Activity No swimming or getting water into canal until ear is healed Signs and Symptoms to return Ear drainage Worsening ear pain PROGNOSIS[urgentcarepeds.org]
  • […] care provider or otolaryngologist may be appropriate if extraction complicated by Canal laceration Tympanic membrane perforation Canal wall hematoma, or Otitis externa Otitis externa and tympanic membrane perforation should be treated appropriately Prognosis[fprmed.com]
  • Prognosis (Outlook) Most people recover completely after having a foreign object removed from the ear. If the skin of the ear canal has been injured, antibiotic drops are frequently prescribed to prevent infection.[emedicinehealth.com]

Etiology

  • […] object such as insect, organic, or inorganic matter in external auditory canal Synopsis Relatively common foreign body complaint in primary care office, urgent care, and emergency room settings May be asymptomatic or an incidental finding Pathophysiology Etiology[fprmed.com]

Epidemiology

  • Aural and nasal foreign bodies in children - epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations. Int J Pediatr Otorhinolaryngol. 2019 Mar. 118:165-9. [Medline].[emedicine.medscape.com]
  • Common removal methods include use of forceps, water irrigation, and suction catheter. [ 1 ] Epidemiology Foreign bodies of the ear are relatively common.[patient.info]
  • The accessibility to modern day communication devices and ammunitions has equally changed the epidemiological outlook of aural foreign bodies among children.[panafrican-med-journal.com]
  • Aetiology and epidemiology Patients presenting with foreign bodies in the nose or ear are predominantly children in the 2 to 8 age group. 2 Foreign bodies in the nose are less common than those in the ear and occur almost exclusively in children.[emj.bmj.com]
Sex distribution
Age distribution

Pathophysiology

  • Definition Foreign object such as insect, organic, or inorganic matter in external auditory canal Synopsis Relatively common foreign body complaint in primary care office, urgent care, and emergency room settings May be asymptomatic or an incidental finding Pathophysiology[fprmed.com]

Prevention

  • There is need for more public education of parents and care givers so as to prevent this avoidable injury.[ncbi.nlm.nih.gov]
  • Mostly non preventable Discourage children from putting anything in the ear Patient Education Describe foreign body in the ear Common foreign bodies Signs/Symptoms Available treatment options & complication Advise on first aid techniques Use gravity[fprmed.com]
  • How to Prevent Foreign Body in Ear Curiosity and exploration of one's body is a natural stage of development. Teaching a child that it is not good to put anything into the ear may prevent some of these mishaps.[emedicinehealth.com]
  • Once the foreign body has been removed, an antibiotic drop along with antibiotics by mouth may be needed to prevent serious infection of the ear.[med.uth.edu]
  • On rare occasions, it may be necessary to remove the object under anesthesia to prevent injury to the eardrum or canal. Insects in the ear canal can occur at any age and cause immediate distress to the patient.[southlakeent.com]

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