Foreign bodies in the ear and the management

1. Foreign bodies
in the ear
Mr. Binu Babu
M.Sc. Nursing
Mrs. Jincy Ealias
M.Sc. Nursing

2.  A foreign body in the ear is anything that gets
stuck in the ear canal other than earwax.

3. Etiology
Anything that is inserted in the ear may get
stuck and cause an ear foreign body. These
things may include; ORGANIC (living or non
living)or INORGANIC
 NON-LIVING
 Sponge
 Eraser
 Paper
 Wood
 Cotton buds

4.  LIVING
 Beans
 Nuts
 Worms
 INORGANIC
 Bead
 Metal
 Stones
 Plastic toys
 Button
 Batery

5. Clinical manifestations
 Feeling of something in the ear
 Ear fullness
 Trouble in hearing
 Itching
 Otalgia (ear ache)
 Fever
 Redness
 Bleeding
 Thick drainage and a foul odor
 If the foreign body is an insect, may feel movement
or hear buzzing.

6. Diagnostic measures
 History collection
 Physical examination
 Otoscopy
 Audiometry

7. Management
Medical management
 Treatment will depend on type of foreign body is in the ear.
Treatment may also depend on how long and how deep the
foreign body is in the ear canal and may include:
 Pharmacological:
 Numbing medicine may be put before trying to remove the
foreign body. Sedative and pain medicines help to stay
comfortable, calm and relaxed.
 Antibiotics to prevent an infection.
The three standard methods for removing foreign bodies are :
 Irrigation
 Suction
 Instrumentation

8.  Procedures: If the object can be seen directly, removal may be
done using any of the following:
 Instruments: Forceps (grasper), hook or curette (scraper) may
be used to remove the foreign body. Alligator forceps /crocodile
forceps can easily graps objects such as cotton wool , paper
,pieces of foam sponge and insects.
 Ear irrigation: Water that is body temperature is used to force
the object out of the canal. Irrigation cannot be used to take out
batteries or objects that may expand when they get wet, such as
seeds. This procedure also cannot be used on people with an
eardrum tear.
 Suction: A machine that sucks out the object from the ear canal
may be used to remove small objects. This procedure uses a
small plastic tube that goes in the ear and is connected to the
machine.
 Chemicals: Hydrogen peroxide or acetone may be used to melt
dried glue. Acetone may also be used to remove gum or plastic
foam.
 Other: Liquid, such as mineral oil, may be used if the foreign
body is a live insect. This is put in the ear to kill the insect first
before taking it out. Once the insect is no longer moving, it is
taken out whole or in pieces using instruments.

9. Surgical management
 Surgery is done if the foreign body is very deep. Surgery
may also be done to treat ear damage caused by the
foreign body.
Nursing management
 Assess for nonverbal signs of ear pain to identify pain.
 Educate the patient not to put fingers or other objects
into the ear.
 Teach patient how to use topical antibiotics, oral
antibiotics, and other medications to promote healing.
 Instruct patient to report any prolonged symptoms of ear
pain, swelling, drainage, or plugged feeling.

10. COMPLICATIONS
 Ear canal abrasions
 Bleeding
 Infection
 perforation of the tympanic membrane.
 Otitis externa / otitis media
 Foreign body granuloma