Ear foreign body: Ear Foreign Body Removal – StatPearls

30.11.197820.11.2021 by alexxlab

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Ear Foreign Body Removal – StatPearls

Continuing Education Activity

The management of foreign bodies located in the external auditory canal can be nuanced, and for some medical professionals, may be intimidating if not performed frequently. This activity reviews the anatomy of the external auditory canal, the technique for removing external auditory canal foreign bodies. It highlights the interprofessional team’s role in ensuring patient comfort and appropriate positioning during the removal of the foreign body.

Objectives:

Identify potential contraindications to the removal of a foreign object from the external auditory canal.
Summarize objects that require emergent removal from the external auditory canal.
Describe the techniques used for the removal of foreign bodies from the external auditory canal.
Outline the importance of collaboration and coordination amongst the interprofessional team to facilitate safe ear foreign body removal to minimize complications and improve patient outcomes.

Access free multiple choice questions on this topic.

Introduction

Many physicians who work in acute care settings, especially those who see pediatric patients, will encounter patients with a foreign body in the external auditory canal (EAC). Depending on the specialty and location of practice, some doctors will encounter this condition more frequently. This section aims to give physicians an understanding of the scope of this condition and some methods for managing a foreign body in the external auditory canal.

While more common in pediatric patients, adults can also present with a foreign body, ranging from insects to hearing air pieces, in the external auditory canal. The most commonly removed foreign bodies include beads (most common), paper/tissue paper, and popcorn kernels.[1][2] These combine to account for just over half of the foreign bodies removed in one study.[2] There may also be a slight male predominance, but not all studies have shown this. [2][3] Certain types of foreign bodies, such as button batteries, do require urgent removal. However, for most inorganic objects, there does not appear to a significant issue with the length of time the foreign body has been in the external auditory canal before attempted removal, though in prolonged retention of foreign bodies, there can be significant swelling of the EAC, which may increase patient discomfort upon attempted removal.

Anatomy and Physiology

The external auditory canal and the outer layer of the tympanic membrane form from the first branchial cleft. The medial two-thirds are bone covered with stratified squamous epithelial skin, while cartilage makes up the outer third. The skin lining the cartilaginous portion of the external auditory canal has hairs and modified sweat glands that secrete cerumen (earwax). Innervation of the external auditory canal is mostly from cranial nerves V3 (mandibular branch) and X. Cranial nerves VII and IX have lesser contributions. The external auditory canal is nearly straight in children, becoming adult-sized, approximately 2.5 cm long, at about nine years old. It becomes more sigmoid in adults with the cartilaginous portion angling posteriorly and superiorly with the bony portion angling anterior inferiorly. As a result, in adults, pulling the helix posterior and superior straightens the external auditory canal and allows for better visualization of the tympanic membrane. Of significant importance for foreign body management, the external auditory canal has two natural narrowings. The first narrowing is at the bony-cartilaginous junction, and the other is just lateral to the tympanic membrane.[4] Another important anatomic feature of the tympanic membrane is the potential blind spot in the tympanic sulcus generated as the tympanic membrane slopes obliquely away from the external auditory canal as it goes inferiorly.

Indications

Indications for this procedure include the presence of a foreign body in the external auditory canal, the appropriate equipment for removing a foreign body in the external auditory canal, and a cooperative patient (or the ability to sedate or restrain the patient safely). [5]

Contraindications

Contraindications to removing a foreign body from the external auditory canal are related to the patient’s cooperativeness, location of the object in the external auditory canal, lack of appropriate tools for removing the foreign body, and the type of foreign body may make methods of removal inappropriate.

An uncooperative patient and the inability to safely sedate an uncooperative patient are contraindications to attempting foreign body removal.

A foreign body lodged against the tympanic membrane, or a foreign body that cannot be grasped easily, such as a hard spherically shaped object, may require specialized equipment not readily available. Specific methods might also be contraindicated in certain situations. For example, irrigation would be contraindicated with a suspected tympanic membrane perforation, removal of organic material, or removal of a battery. It may also be contraindicated if the suspected foreign body is made of a spongy material that may swell and enlarge if hydrated. [5]

Equipment

Multiple options exist for the removal of external auditory canal foreign bodies. Which piece of equipment to use will be influenced by the type and shape of the foreign body, its location, and the patient’s cooperativeness.[4]

Commonly used equipment include alligator forceps, cup forceps, right-angle hook, balloon catheters, such as a Fogarty catheter, or Rosen needle. The use of fine, sharper instruments is greatly facilitated by binocular microscopy.[4]

Irrigation is another common option, and this can be performed by attaching an angiocatheter to a 20 mL to 30 mL syringe. Alternatively, modifying a butterfly catheter by cutting off the needle and then attaching the remaining tubing to the syringe. Great care must be taken with blind irrigation as an unknown tympanic membrane perforation may exist. Some authors advise against the irrigation of the EAC unless the tympanic membrane can be visualized to ensure it is intact.[4]

Suction is also an option and usually is performed with a Frazier suction under microscopic guidance. [4]

Another potential method uses cyanoacrylate (superglue) or tissue glue applied to the blunt end of a cotton-tipped applicator and then placed against the foreign body, so the glue adheres to it, and both the foreign body and applicator can be removed from the external auditory canal together.[4][6]

Personnel

In a cooperative patient, it is possible to remove a foreign body from the external auditory canal by a single provider. Depending on how cooperative the patient is, one or more assistants may be required to maintain the patient in the proper position and keep the patient still. This is especially common in pediatric patients.[5]

Preparation

Evaluation should include noting any injury to the external auditory canal and tympanic membrane before removal attempts. The patient’s hearing should also be assessed, especially if there is suspicion for tympanic membrane injury/perforation or middle ear injury once the foreign body is removed. If the patient complains of hearing loss before the foreign body is removed, audiometry or tuning fork testing should be used to ensure an appropriate conductive loss is demonstrated. If the hearing loss is greater than expected, or a sensorineural hearing loss is encountered, the patient should be urgently referred to an otolaryngologist for evaluation and removal, likely in the operating room.

Patient positioning is important. Cooperative patients can either sit or lie down with the affected ear turned towards the provider. For younger children, there are several options for positioning. The patient can sit in the parent’s lap with the parent holding the patient’s body with one hand and the other around the head with the head turned. The patient can also lie down, either supine or prone, on the stretcher with their head turned.[7]

Technique

Before beginning the procedure, the physician should determine how many attempts will be made (usually only one or two) and, if planning more than one attempt, what technique should be used for the subsequent attempt. If unsuccessful after one or two attempts, further attempts should be aborted, and the patient should be referred to an ear, nose, and throat (ENT) specialist. Consider examining the contralateral ear and nose for other foreign bodies as well, particularly in children.

Specific Techniques

Manual instrumentation (e.g., forceps, curettes, angle hook)

These are typically used in conjunction with the operating head of an otoscope but can also be used with the diagnostic head. Binocular microscopy is ideal, though it may not be available in all settings. The pinna should be retracted, and the object in the ear canal visualized. When using forceps, the foreign body can be grasped and removed. Both curettes and right-angle hooks should be gently maneuvered behind the foreign body and rotated, so the end is behind it, which can then be pulled out.[4]

Irrigation

This can be performed with either an angiocatheter or a section of tubing from a butterfly syringe. Using body temperature water, retract the pinna, and squirt water superiorly in the external auditory canal, behind the foreign body, which will then be washed out of the canal. [4]

Suction

This should be performed with a suction tipped catheter with a thumb-controlled release valve, such as a Frazier tip. Insert the suction against the foreign body under direct visualization, activate the suctions, remove the object, and maintain suction until the foreign body is completely out of the external auditory canal.[4]

Cyanoacrylate

Apply a small amount of cyanoacrylate or skin glue to the blunt end of a cotton-tipped applicator. Once the glue is tacky, insert it against the foreign body under direct visualization and hold it in place until the glue dries. Once the object is secured onto the applicator, it can be removed by removing the applicator.[4]

Insect Removal

The first step is to kill the insect, allowing the patient to be more comfortable and allow for the removal of the insect. There are multiple recommended agents for killing the insect. Studies indicate that mineral oil is the most effective, followed by lidocaine. [8] Both can be instilled in the external auditory canal, and once the insect is neutralized, it can be removed by any of the above methods. In practice, lidocaine offers the advantage of anesthetizing the EAC as the insect struggles, potentially scratching the EAC and causing pain.[4]

Complications

The most common complications from foreign bodies in the external auditory canal and attempts to remove them include excoriations and lacerations of the external auditory canal. As a result, it is important to document a pre-removal and post-removal exam, noting the presence of any pre-removal injuries. These typically heal rapidly by keeping the external auditory canal clean and dry. Antibiotic eardrops can be considered as well. Much rarer and much more serious foreign body removal complications include tympanic membrane perforation or ossicular chain damage. These are potentially devastating and should be avoided at all costs. If the physician is unable to, or uncomfortable with, removing EAC foreign bodies, then the patient should be referred to an otolaryngologist. [7]

Clinical Significance

Physicians involved in acute patient care can expect to manage patients with a foreign body in the external auditory canal during their careers. As such, it is important to recognize both provider skill and equipment limitations. The type and location of the object in the external auditory canal, along with the patient’s ability to cooperate, are the key factors in determining whether an attempt should be made. Referral to a specialist or a location where sedation can be performed is recommended if the removal is not practical after the initial evaluation. In general, complications tend to be minor and easily managed.

Enhancing Healthcare Team Outcomes

Successful removal of an ear foreign body requires a cooperative patient and may require the assistance of family members as well as other medical team members. Patient positioning and a well thought out plan are keys to the success of the procedure. Explaining to patients and family what will happen and gaining their cooperation is important. Involving family members and/or staff members for positioning can be very helpful. Another consideration is the use of medications for anxiolysis or procedural sedation to facilitate patient cooperation. This requires appropriate ancillary staff, such as nursing for intravenous line placement and medication administration and possibly anesthesia or respiratory therapy to assist in airway monitoring. With appropriate team coordination, this procedure can be performed safely and rapidly with low risk for complication and minimal stress for the patient. All members of the interprofessional team, most notably clinicians (including PAs and NPs) and nurses, should be able to identify the problem, assist experienced hands in foreign body removal, or know when to refer the patient in more complicated cases. This will result in better patient outcomes. [Level 5]

Figure

Alligator Forceps. Contributed by Seth Lotterman, MD

References

1.: Thompson SK, Wein RO, Dutcher PO. External auditory canal foreign body removal: management practices and outcomes. Laryngoscope. 2003 Nov;113(11):1912-5. [PubMed: 14603046]
2.: Schulze SL, Kerschner J, Beste D. Pediatric external auditory canal foreign bodies: a review of 698 cases. Otolaryngol Head Neck Surg. 2002 Jul;127(1):73-8. [PubMed: 12161734]
3.: Marin JR, Trainor JL. Foreign body removal from the external auditory canal in a pediatric emergency department. Pediatr Emerg Care. 2006 Sep;22(9):630-4. [PubMed: 16983246]
4.: Falcon-Chevere JL, Giraldez L, Rivera-Rivera JO, Suero-Salvador T. Critical ENT skills and procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):29-58. [PubMed: 23200328]
5.: Friedman EM. VIDEOS IN CLINICAL MEDICINE. Removal of Foreign Bodies from the Ear and Nose. N Engl J Med. 2016 Feb 18;374(7):e7. [PubMed: 26886547]
6.: Benger JR, Davies PH. A useful form of glue ear. J Accid Emerg Med. 2000 Mar;17(2):149-50. [PMC free article: PMC1725351] [PubMed: 10718247]
7.: Davies PH, Benger JR. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. J Accid Emerg Med. 2000 Mar;17(2):91-4. [PMC free article: PMC1725343] [PubMed: 10718227]
8.: Leffler S, Cheney P, Tandberg D. Chemical immobilization and killing of intra-aural roaches: an in vitro comparative study. Ann Emerg Med. 1993 Dec;22(12):1795-8. [PubMed: 8239097]

Ear Foreign Body Removal – StatPearls

Continuing Education Activity

Objectives:

Identify potential contraindications to the removal of a foreign object from the external auditory canal.
Summarize objects that require emergent removal from the external auditory canal.
Describe the techniques used for the removal of foreign bodies from the external auditory canal.
Outline the importance of collaboration and coordination amongst the interprofessional team to facilitate safe ear foreign body removal to minimize complications and improve patient outcomes.

Access free multiple choice questions on this topic.

Introduction

While more common in pediatric patients, adults can also present with a foreign body, ranging from insects to hearing air pieces, in the external auditory canal. The most commonly removed foreign bodies include beads (most common), paper/tissue paper, and popcorn kernels.[1][2] These combine to account for just over half of the foreign bodies removed in one study.[2] There may also be a slight male predominance, but not all studies have shown this.[2][3] Certain types of foreign bodies, such as button batteries, do require urgent removal. However, for most inorganic objects, there does not appear to a significant issue with the length of time the foreign body has been in the external auditory canal before attempted removal, though in prolonged retention of foreign bodies, there can be significant swelling of the EAC, which may increase patient discomfort upon attempted removal.

Anatomy and Physiology

The external auditory canal and the outer layer of the tympanic membrane form from the first branchial cleft. The medial two-thirds are bone covered with stratified squamous epithelial skin, while cartilage makes up the outer third. The skin lining the cartilaginous portion of the external auditory canal has hairs and modified sweat glands that secrete cerumen (earwax). Innervation of the external auditory canal is mostly from cranial nerves V3 (mandibular branch) and X. Cranial nerves VII and IX have lesser contributions. The external auditory canal is nearly straight in children, becoming adult-sized, approximately 2.5 cm long, at about nine years old. It becomes more sigmoid in adults with the cartilaginous portion angling posteriorly and superiorly with the bony portion angling anterior inferiorly. As a result, in adults, pulling the helix posterior and superior straightens the external auditory canal and allows for better visualization of the tympanic membrane. Of significant importance for foreign body management, the external auditory canal has two natural narrowings. The first narrowing is at the bony-cartilaginous junction, and the other is just lateral to the tympanic membrane. [4] Another important anatomic feature of the tympanic membrane is the potential blind spot in the tympanic sulcus generated as the tympanic membrane slopes obliquely away from the external auditory canal as it goes inferiorly.

Indications

Contraindications

An uncooperative patient and the inability to safely sedate an uncooperative patient are contraindications to attempting foreign body removal.

Equipment

Suction is also an option and usually is performed with a Frazier suction under microscopic guidance.[4]

Personnel

Preparation

Technique

Specific Techniques

Manual instrumentation (e.g., forceps, curettes, angle hook)

Irrigation

Suction

Cyanoacrylate

Insect Removal

The first step is to kill the insect, allowing the patient to be more comfortable and allow for the removal of the insect. There are multiple recommended agents for killing the insect. Studies indicate that mineral oil is the most effective, followed by lidocaine.[8] Both can be instilled in the external auditory canal, and once the insect is neutralized, it can be removed by any of the above methods. In practice, lidocaine offers the advantage of anesthetizing the EAC as the insect struggles, potentially scratching the EAC and causing pain.[4]

Complications

Clinical Significance

Enhancing Healthcare Team Outcomes

Figure

Alligator Forceps. Contributed by Seth Lotterman, MD

References

1.: Thompson SK, Wein RO, Dutcher PO. External auditory canal foreign body removal: management practices and outcomes. Laryngoscope. 2003 Nov;113(11):1912-5. [PubMed: 14603046]
2.: Schulze SL, Kerschner J, Beste D. Pediatric external auditory canal foreign bodies: a review of 698 cases. Otolaryngol Head Neck Surg. 2002 Jul;127(1):73-8. [PubMed: 12161734]
3.: Marin JR, Trainor JL. Foreign body removal from the external auditory canal in a pediatric emergency department. Pediatr Emerg Care. 2006 Sep;22(9):630-4. [PubMed: 16983246]
4.: Falcon-Chevere JL, Giraldez L, Rivera-Rivera JO, Suero-Salvador T. Critical ENT skills and procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):29-58. [PubMed: 23200328]
5.: Friedman EM. VIDEOS IN CLINICAL MEDICINE. Removal of Foreign Bodies from the Ear and Nose. N Engl J Med. 2016 Feb 18;374(7):e7. [PubMed: 26886547]
6.: Benger JR, Davies PH. A useful form of glue ear. J Accid Emerg Med. 2000 Mar;17(2):149-50. [PMC free article: PMC1725351] [PubMed: 10718247]
7.: Davies PH, Benger JR. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. J Accid Emerg Med. 2000 Mar;17(2):91-4. [PMC free article: PMC1725343] [PubMed: 10718227]
8.: Leffler S, Cheney P, Tandberg D. Chemical immobilization and killing of intra-aural roaches: an in vitro comparative study. Ann Emerg Med. 1993 Dec;22(12):1795-8. [PubMed: 8239097]

Ear Foreign Body Removal – StatPearls

Continuing Education Activity

Objectives:

Identify potential contraindications to the removal of a foreign object from the external auditory canal.
Summarize objects that require emergent removal from the external auditory canal.
Describe the techniques used for the removal of foreign bodies from the external auditory canal.
Outline the importance of collaboration and coordination amongst the interprofessional team to facilitate safe ear foreign body removal to minimize complications and improve patient outcomes.

Access free multiple choice questions on this topic.

Introduction

While more common in pediatric patients, adults can also present with a foreign body, ranging from insects to hearing air pieces, in the external auditory canal. The most commonly removed foreign bodies include beads (most common), paper/tissue paper, and popcorn kernels.[1][2] These combine to account for just over half of the foreign bodies removed in one study.[2] There may also be a slight male predominance, but not all studies have shown this.[2][3] Certain types of foreign bodies, such as button batteries, do require urgent removal. However, for most inorganic objects, there does not appear to a significant issue with the length of time the foreign body has been in the external auditory canal before attempted removal, though in prolonged retention of foreign bodies, there can be significant swelling of the EAC, which may increase patient discomfort upon attempted removal.

Anatomy and Physiology

Indications

Contraindications

An uncooperative patient and the inability to safely sedate an uncooperative patient are contraindications to attempting foreign body removal.

Equipment

Suction is also an option and usually is performed with a Frazier suction under microscopic guidance.[4]

Personnel

Preparation

Technique

Specific Techniques

Manual instrumentation (e.g., forceps, curettes, angle hook)

Irrigation

Suction

Cyanoacrylate

Insect Removal

The first step is to kill the insect, allowing the patient to be more comfortable and allow for the removal of the insect. There are multiple recommended agents for killing the insect. Studies indicate that mineral oil is the most effective, followed by lidocaine.[8] Both can be instilled in the external auditory canal, and once the insect is neutralized, it can be removed by any of the above methods. In practice, lidocaine offers the advantage of anesthetizing the EAC as the insect struggles, potentially scratching the EAC and causing pain.[4]

Complications

Clinical Significance

Enhancing Healthcare Team Outcomes

Figure

Alligator Forceps. Contributed by Seth Lotterman, MD

References

1.: Thompson SK, Wein RO, Dutcher PO. External auditory canal foreign body removal: management practices and outcomes. Laryngoscope. 2003 Nov;113(11):1912-5. [PubMed: 14603046]
2.: Schulze SL, Kerschner J, Beste D. Pediatric external auditory canal foreign bodies: a review of 698 cases. Otolaryngol Head Neck Surg. 2002 Jul;127(1):73-8. [PubMed: 12161734]
3.: Marin JR, Trainor JL. Foreign body removal from the external auditory canal in a pediatric emergency department. Pediatr Emerg Care. 2006 Sep;22(9):630-4. [PubMed: 16983246]
4.: Falcon-Chevere JL, Giraldez L, Rivera-Rivera JO, Suero-Salvador T. Critical ENT skills and procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):29-58. [PubMed: 23200328]
5.: Friedman EM. VIDEOS IN CLINICAL MEDICINE. Removal of Foreign Bodies from the Ear and Nose. N Engl J Med. 2016 Feb 18;374(7):e7. [PubMed: 26886547]
6.: Benger JR, Davies PH. A useful form of glue ear. J Accid Emerg Med. 2000 Mar;17(2):149-50. [PMC free article: PMC1725351] [PubMed: 10718247]
7.: Davies PH, Benger JR. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. J Accid Emerg Med. 2000 Mar;17(2):91-4. [PMC free article: PMC1725343] [PubMed: 10718227]
8.: Leffler S, Cheney P, Tandberg D. Chemical immobilization and killing of intra-aural roaches: an in vitro comparative study. Ann Emerg Med. 1993 Dec;22(12):1795-8. [PubMed: 8239097]

Ear Foreign Body Removal – StatPearls

Continuing Education Activity

Objectives:

Identify potential contraindications to the removal of a foreign object from the external auditory canal.
Summarize objects that require emergent removal from the external auditory canal.
Describe the techniques used for the removal of foreign bodies from the external auditory canal.
Outline the importance of collaboration and coordination amongst the interprofessional team to facilitate safe ear foreign body removal to minimize complications and improve patient outcomes.

Access free multiple choice questions on this topic.

Introduction

While more common in pediatric patients, adults can also present with a foreign body, ranging from insects to hearing air pieces, in the external auditory canal. The most commonly removed foreign bodies include beads (most common), paper/tissue paper, and popcorn kernels.[1][2] These combine to account for just over half of the foreign bodies removed in one study.[2] There may also be a slight male predominance, but not all studies have shown this.[2][3] Certain types of foreign bodies, such as button batteries, do require urgent removal. However, for most inorganic objects, there does not appear to a significant issue with the length of time the foreign body has been in the external auditory canal before attempted removal, though in prolonged retention of foreign bodies, there can be significant swelling of the EAC, which may increase patient discomfort upon attempted removal.

Anatomy and Physiology

Indications

Contraindications

An uncooperative patient and the inability to safely sedate an uncooperative patient are contraindications to attempting foreign body removal.

Equipment

Suction is also an option and usually is performed with a Frazier suction under microscopic guidance.[4]

Personnel

Preparation

Technique

Specific Techniques

Manual instrumentation (e.g., forceps, curettes, angle hook)

Irrigation

Suction

Cyanoacrylate

Insect Removal

The first step is to kill the insect, allowing the patient to be more comfortable and allow for the removal of the insect. There are multiple recommended agents for killing the insect. Studies indicate that mineral oil is the most effective, followed by lidocaine.[8] Both can be instilled in the external auditory canal, and once the insect is neutralized, it can be removed by any of the above methods. In practice, lidocaine offers the advantage of anesthetizing the EAC as the insect struggles, potentially scratching the EAC and causing pain.[4]

Complications

Clinical Significance

Enhancing Healthcare Team Outcomes

Figure

Alligator Forceps. Contributed by Seth Lotterman, MD

References

1.: Thompson SK, Wein RO, Dutcher PO. External auditory canal foreign body removal: management practices and outcomes. Laryngoscope. 2003 Nov;113(11):1912-5. [PubMed: 14603046]
2.: Schulze SL, Kerschner J, Beste D. Pediatric external auditory canal foreign bodies: a review of 698 cases. Otolaryngol Head Neck Surg. 2002 Jul;127(1):73-8. [PubMed: 12161734]
3.: Marin JR, Trainor JL. Foreign body removal from the external auditory canal in a pediatric emergency department. Pediatr Emerg Care. 2006 Sep;22(9):630-4. [PubMed: 16983246]
4.: Falcon-Chevere JL, Giraldez L, Rivera-Rivera JO, Suero-Salvador T. Critical ENT skills and procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):29-58. [PubMed: 23200328]
5.: Friedman EM. VIDEOS IN CLINICAL MEDICINE. Removal of Foreign Bodies from the Ear and Nose. N Engl J Med. 2016 Feb 18;374(7):e7. [PubMed: 26886547]
6.: Benger JR, Davies PH. A useful form of glue ear. J Accid Emerg Med. 2000 Mar;17(2):149-50. [PMC free article: PMC1725351] [PubMed: 10718247]
7.: Davies PH, Benger JR. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. J Accid Emerg Med. 2000 Mar;17(2):91-4. [PMC free article: PMC1725343] [PubMed: 10718227]
8.: Leffler S, Cheney P, Tandberg D. Chemical immobilization and killing of intra-aural roaches: an in vitro comparative study. Ann Emerg Med. 1993 Dec;22(12):1795-8. [PubMed: 8239097]

PEM Pearls: Search & Rescue of Ear Foreign Bodies

While ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.¹ The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by understanding what tools are at your disposal.

Emergency physicians have a high success rate (77%) in removing ear foreign bodies with direct visualization.² Otolaryngology uses otomicroscopy, a binocular microscope, for difficult cases.

When attempting direct visualization, the keys to success are:

Adequate visualization
Appropriate equipment
Cooperative patient

Risk factors that indicate difficult removal via direct visualization and should be considered for referral to an otolaryngology specialist include:

Spherical objects²
Sharp objects³
Objects touching the tympanic membrane²
Object in ear canal for more than 24 hours²
Signs of trauma to ear canal (bleeding, limited visibility)
Multiple attempts^1,4

Multiple attempts increases the complication rate the greatest. In one study the complication rate reached 100% when patient had removal attempted 3 times with direct visualization.^1,4 Thus no more than 2 attempts should be made while in the ED, to minimize swelling, bleeding, and other complications.

Ensure good lighting with a headlamp or direct lighting is necessary for easy removal. Example: Pediatric video laryngoscope (Miller 0 blade) can also help obtain better visualization.
Do not use restraints or force when possible. This will usually make exam more difficult in young patients.
Utilize child calming techniques and child life specialists when available. Have parents to assist with exam.
In children <5 years old, procedural sedation or intranasal sedative is encouraged, if a difficult foreign body or uncooperative child is suspected.
Use topical lidocaine in ear canal for analgesia, although this is contraindicated in tympanic membrane perforations.

There are many options to remove various shapes and sizes of foreign bodies. Below are the techniques and pros and cons of each:

Alligator Forceps

Tool: May need to get smaller varieties from operating room or otolaryngology clinic if not readily available in the ED
Pros: Commonly available, most commonly used,² and able to grasp ridged or solid objects
Cons: Less successful with spherical foreign bodies²

Irrigation

Tool: 60 mL syringe, butterfly needle (needle cut off), room temp water/saline
Irrigation options: Normal saline, alcohol, 2% lidocaine, or mineral oil
Pros: Effective for non-ridged items and those loosely lodged in ear canal
Contraindications:
- Disk batteries due to risk of liquefaction necrosis²
- Organic material due to risk of expansion damaging the ear canal²
- Suspected tympanic membrane perforation (including a myringotomy tube)
- Monomeric or dimeric tympanic membrane (a thin, weak area of the membrane where one or two layers have healed after perforation)
- History of ear surgery

Schuknecht suction catheter (AKA Frazier suction device)

Tool: Elongated and narrow suction catheter; see ALiEM trick of the trade
Pros: Non-grasping thus better success with spherical foreign bodies
Cons: May need to get from operating room or otolaryngology clinic if not readily available in the ED. Some irregular objects will be difficult to get a suction seal around.

Bionix ear curette

With permission of Bionix Development Corporation

Tool: Illuminating curette (comes in a forceps form)
Pros:
- Similar usability as alligator forceps
- Built in light source and magnification to assist with good visualization.
- Scoop at tip to help with cerumen impaction.
Cons: May not be available in your department

Cerumen loops

Tool: Metal or plastic loops
Pros: Commonly available; useful for ear wax removal
Cons: Unable to grasp

Right angle ball hook

Tool: Insert hook beyond object, turn 90 degrees, and retract.
Pros: Non-grasping and thus better success with spherical foreign bodies
Cons: Not ideal for objects close to the tympanic membrane

Cyanoacrylate “super” glue impregnated long Q-Tip sticks

With permission of Michelle Lin, MD

Tool:
- Apply a few drops of adhesive on the wood stick end of a long Q-tip.
- Insert and apply to foreign body.
- Allow drying for 20-30 seconds.
- Remove foreign body and Q-tip as a unit
- Variation on the trick: Insert an otoscope speculum into the ear to protect the canal from inadvertent adhesive contact before inserting the long Q-tip
- More detailed explanation of trick
Pros: Useful for spherical foreign bodies
Cons: Requires cooperative patient to allow the adhesive to dry

Telescoping magnet

Tool:
- Can be bought from most hardware stores
- Magnet head <0.75 cm
- Used to grab hold of metal objects
Pros: Useful for metal or magnetic objects that are freely moving; can use for lodged disk batteries
Cons: Limited ability to directly visualize when in ear canal

Acetone (nail polish remover)

Tool: Over the counter nail polish remover (60~70% acetone)
- Dissolves styrofoam foreign bodies
- For super glue removal⁵
  - Instill in ear canal and wait 30 minutes.
  - Add local anesthetic.
  - Use direct visualization tool to peel off.
Pros: Low in ototoxicity risk; rapidly evaporating
Contraindicated for suspected tympanic membrane perforation (including a myringotomy tube)

Kill the insect prior to removal
Instill alcohol, 2% lidocaine, or mineral oil into ear canal.
- Contraindicated for suspected tympanic membrane perforation (including a myringotomy tube)
Detailed procedure instructions

Notable foreign bodies removed from the ear by our pediatric emergency department staff include: Barbie shoe, piece of Gak, Button from a Nintendo controller, and a primary tooth.

Having the right tool for the job is important in order to reduce attempts, below are some quick recommendations on what to to use first.

Ansley J, Cunningham M. Treatment of aural foreign bodies in children. Pediatrics. 1998;101(4 Pt 1):638-641. [PubMed]

Schulze S, Kerschner J, Beste D. Pediatric external auditory canal foreign bodies: a review of 698 cases. Otolaryngol Head Neck Surg. 2002;127(1):73-78. [PubMed]

Heim S, Maughan K. Foreign bodies in the ear, nose, and throat. Am Fam Physician. 2007;76(8):1185-1189. [PubMed]

Bressler K, Shelton C. Ear foreign-body removal: a review of 98 consecutive cases. Laryngoscope. 1993;103(4 Pt 1):367-370. [PubMed]

Anusha B, Purushotman R, Lina L, Avatar S. Superglue accidentally used as ear drops. Med J Malaysia. 2012;67(2):212-213. [PubMed]

Pediatric Ear Foreign Bodies ENT Treatment in Utah

Ear Foreign Bodies

Ear Foreign Bodies – About

A foreign body means something that is stuck inside you but isn’t supposed to be there. Foreign bodies are more common in small children, who sometimes stick things in their mouths, ears, and noses.

Young children may place objects into their ears for various reasons. Often, they are playing or copying another child. Objects that commonly become stuck in a child’s ear are crayon tips, beads, toys, and food. Multiple foreign bodies are not uncommon, especially in small children. Thus, all other orifices of the head (nose and throat) should be inspected after removal of a foreign body from the ear.

In adults, insects are the foreign bodies most commonly found in the ear (eg, cockroaches, moths, flies, household ants).

Children also commonly place objects into their noses. These objects often include pencil erasers, nuts, and small toys.

Many techniques are used to remove ear foreign bodies are available, depending on the situation and the type of foreign body. Options include water irrigation, forceps removal and suction catheters. Removal of foreign bodies can become complicated and may be best performed by an Ear Nose and Throat physician.

Ear Foreign Bodies – Diagnosis

Most adults are able to tell their doctor or healthcare provider that there is something in their ear, but this is not always true. For example, an older adult with a hearing aid may lose a button battery or hearing aid in their canal and not realize it. Patients may have hearing loss or sense of fullness.

Children, depending on age, may be able to indicate that they have a foreign body, or they may present with complaints of ear pain or discharge.

Patients may be in significant discomfort and complain of nausea or vomiting if a live insect is in the ear canal. Insects may injure the canal or tympanic membrane by scratching or stinging.

Pain or bleeding may occur with objects that scratch the ear canal or rupture the tympanic membrane or from the patient’s attempts to remove the object.

If the foreign body has been lodged in the ears for some time there may be swelling or inflammation of the ear canal and a foul-smelling discharge may be present.

Ear Foreign Bodies – Treatment

If you can see the foreign body in the ear and remove it easily, carefully do so using tweezers. Never poke at the ear or try to remove the object by force. Because failed attempts to remove the foreign body can push the object in deeper, damage the ear canal or damage the eardrum it is often best to seek medical attention.

Irrigation is the simplest method of foreign body removal, provided the tympanic membrane (eardrum) is not perforated. Irrigation with water is not recommended for soft objects, organic matter, or seeds, which may swell if exposed to water. Suction is sometimes a useful means of foreign body removal.

Foreign Body in Ear | causes, diagnosis, treatment, prevention

By Medicover Hospitals / 10 Mar 2021
Home | symptoms | foreign-body-in-ear

Foreign bodies in the ear, relatively common in an emergency, are most often, but not exclusively, seen in children. Various objects can be found in the ear, including toys, beads, stones, folded paper, and biological materials such as insects or seeds. Most foreign objects in the ear and nose can be removed with minimal risk of complications. Common removal methods include the use of forceps, water irrigation, and a suction catheter.

Article Context:

What is Foreign Body In The Ear?
Causes
Diagnosis
Treatment
When to visit a Doctor?
Prevention
FAQ’s

What is Foreign Body In The Ear?

Foreign objects in the ear are common reasons for emergency room visits, especially among children.

Most of these things are harmless.
Some are extremely uncomfortable, while others can quickly cause infection requiring emergency treatment.

If you are unsure of the potential for foreign body damage, seek medical attention immediately.
Most objects stuck in the ear canal are placed there by the person themselves. Children who are curious about their bodies and interesting objects are the group most often faced with this problem.
The most common things they put in their ears include:

Pearls
Food (especially seeds)
Paper
Q-tips
Rubber erasers
Small toys
Marbles
Small seashells

Ear wax: Earwax is a substance naturally present in the ear canal, but can become a problem when it builds up where it obstructs the ear canal and causes hearing loss or pain. Excessive use of cotton swabs such as Q-Tips to clean the ear can actually push wax and cellular debris from the skin further into the canal and press them against the eardrum, causing symptoms.
Insects: Insects can also fly or crawl in the ear canal. Usually, it happens by sleeping on the ground or outdoors. It is often a frightening and dramatic event because the buzzing and movements of the insect are very loud and sometimes painful.

Causes:

Some objects placed in the ear may not cause signs. Other objects, such as food and bugs, can cause ear pain, hearing loss, redness, or drainage. Hearing can be affected if the object blocks the ear canal.

Diagnosis:

Your doctor will use a lighted magnifying glass called an otoscope to look inside the ear canal, see the object, and also see if you have an infection or a torn eardrum.

Treatment:

Treatment of an object in the ear usually involves removing the object. The ease or difficulty of this process depends on where the object is in the body. If the item cannot be removed at home and medical attention is required, treatment may include the following:

A suction machine can remove the object from the nose or the ear.
Retractors can also remove an object.
Magnets can sometimes remove metal objects.

Sometimes surgery is necessary if other removal methods do not work. Further processing may involve dealing with any damage caused by the object.

When to visit a Doctor?

Most objects that get lodged in the ear should prompt you to call a doctor. If this item is not causing any symptoms and the doctor’s office is closed, an assessment can usually wait until the next morning.

Depending on your particular medical community, your doctor may want to see you in the office or refer you to a local emergency department or other specialists. Don’t expect a healthcare professional to properly assess the situation over the phone. If you have a problem with a foreign object in the ear, have you physically examined it by a qualified healthcare professional.

Persistent pain, bleeding, or discharge from the ear may mean that the ear passages have not been completely cleared, that part of the object may remain inside the ear, or that an infection of the ear canal has developed. These infections respond well to antibiotic drops, but a test and a prescription are needed.
A foreign object in the ear can also damage the eardrum, which may or may not affect hearing. Since you cannot see the eardrum from the outside, an ear exam is recommended.

In most cases, the situation of having something in the ear will not be life-threatening. Usually, you will have time to call your doctor. The urgency of the situation depends mainly on the location of the object and the substance involved.

Button batteries commonly found in many small devices and toys can break down enough in the body to allow chemicals to escape and cause burns. Urgent withdrawal is advised.
Urgent disposal is also recommended for food or plant materials (such as seeds) as these swell when moistened.
An urgent examination is indicated if the object causes significant pain or discomfort, or if there is severe hearing loss or dizziness.

Prevention:

Here are some important steps to take to keep the object in the ear:

Try to see if the object will fall just by tilting your child’s head.
If you can see the object in the ear and think you can remove it easily, gently remove it with tweezers. Be careful not to push it any deeper, push the ear, or try to remove the object by force. The ear canal is very sensitive and it can be painful.
If it is a live insect, kill it before trying to remove it. Put a few drops of warm (not too hot oil) baby oil or vegetable oil in the ear. Have your child tilt and gently shake their head to dislodge the insect. Do not use this method for anything other than an insect, and do not use it if your child is in pain, the ear is bleeding, or has tubes in the ear.
If you are sure the eardrum is not injured and your child does not have an ear tube, try washing the object off with a little lukewarm water.

You should see your doctor immediately if you cannot easily extract the object on your own or if parts of it remain in the ear. You should also get medical help if you have pain, hearing loss, or discomfort after removing the item.

Frequently Asked Questions:

A foreign object cannot fall out of your ear on its own. It can stay in your ear until you don’t take it out or take it out. Small, inert foreign bodies, such as pearls, can stay in your ear for 1 to 2 weeks without causing complications.

Try to see if the object will fall just by tilting your child’s head. If you can see the object in the ear and think you can remove it easily, gently remove it with tweezers. Be careful not to push it any deeper, push the ear out, or try to forcefully remove the object.

The most effective home treatment is to place oil drops in the ear. Many household oils, such as mineral oil, baby oil, and even olive oil, can soften hard, impacted earwax.

Citations:

Ear Foreign Body – https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/611076

Ear Foreign Body – https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.5541030401

Ear Foreign Body – https://www.sciencedirect.com/science/article/abs/pii/S0165587698001189

90,000 Removal of a foreign body from the ear in Moscow

The ear canal provides reliable protection against foreign objects entering the ear. It narrows towards the eardrum, preventing damage to it. The safety of the membrane is ensured by a system of small bends, and therefore small foreign bodies can get inside, and it is very difficult to remove them outside.

Important! Removal of a foreign body from the ear should be performed by an otolaryngologist. Independent attempts to extract, as well as leaving the object inside, are fraught with consequences: damage and injury, purulent-inflammatory processes and even hearing loss.

How to determine the presence of a foreign body in the ear

Signs of a foreign body in the ear depend on what is inside. So, a small bead will not cause discomfort for several days or even weeks. They are often found by pediatric otolaryngologists when examining young patients with ear inflammation and discharge.

If the foreign body has sharp edges, bloody discharge may appear. When an insect hits, many patients notice noise and a characteristic loud buzzing.

Common possible symptoms of a foreign object include pain, swelling and redness of the auricle, itching.

Diagnostics and extraction features

When contacting a doctor, it is necessary to tell about the disturbing symptoms, as well as your assumptions about what could be in the ear. Often for accurate diagnosis – determining the size, nature and location of a foreign body, as well as the condition of the tympanic membrane – a standard otoscopy is sufficient.However, in some cases, it is important to exclude possible complications using an X-ray.

Removal of a foreign body from the ear is possible in several ways:

Using tweezers. This method is used in cases when a piece of paper, cotton wool, a match or a similar object that is easy to pick up with an instrument has hit the ear. The procedure does not cause painful sensations and is carried out quickly enough.
Washing.This method is useful for removing round solid objects that are difficult to grasp with tweezers (for example, beads). For this, a special ear syringe is used, through which the doctor injects water, saline or a drug of warm temperature into the ear. The fluid exerts pressure on the object and it is drained out of the ear canal. The procedure can cause discomfort, therefore, in young patients it is performed under local anesthesia.
Using hooks.The use of special thin hooks is advisable in cases where the foreign body is rather large and closes the ear canal. The specialist carefully winds the hook on the object, grabs it and removes it from the ear. The hooks have no sharp elements, so you shouldn’t be afraid of injury.
With oil or glycerin. This method is relevant for cases when a living insect acts as a foreign body. The fluid is heated to a comfortable temperature, and the doctor instills it into the ear canal.The insect dies, after which the rinsing method is applied.

It is important to know that the removal of a foreign body from the ear may be delayed for several days if the condition is accompanied by an acute inflammatory process. This will avoid painful sensations and complications of the procedure. The doctor will prescribe antibiotic therapy, and after the onset of relief, the object is removed in the chosen way.

Doctors of the Family Doctor clinic successfully remove foreign bodies and sulfur plugs from the ear.

To make an appointment at a convenient time for you, call the unified contact center in Moscow +7 (495) 775 75 66, fill out the online registration form or contact the clinic’s registry.

Cost

otorhinolaryngologist

otorhinolaryngologist, Ph.D.

otorhinolaryngologist, leading specialist of the clinic

ENT specialist, Ph.M.Sc.

otorhinolaryngologist, leading specialist of the clinic

otorhinolaryngologist

Foreign bodies of lororgan

Ear foreign bodies

Ear foreign bodies are most common in children.

There are two types – living and non-living foreign bodies.

Inanimate – small objects (buttons, beads, peas, seeds, small parts from toys, etc.)

Symptoms and course: A foreign body of an inanimate ear in some cases may not cause any discomfort in the patient. This usually applies to small and smooth items. A larger foreign body in the ear, obstructing the passage of a sound wave through the auditory tube, causes hearing loss and a feeling of ear congestion.An ear foreign body with sharp protrusions can injure the skin of the ear canal or eardrum, resulting in pain and bleeding from the ear. It is capable of perforating the eardrum. As a result of perforation, an infection can enter the middle ear cavity, leading to the appearance of otitis media. To make a diagnosis, an otoscopy is performed (examination of the ear canal and tympanic membrane using the ear funnel), if a foreign body enters the tympanic cavity, an X-ray examination is performed (X-ray of the temporal bones, CT, MRI).

First aid: It is necessary to contact the nearest hospital as soon as possible in order to receive qualified and high-quality ENT care.

What not to do: It is strictly forbidden to remove them on your own, as any attempts will only contribute to further pushing into the interior of the ear canal and the possibility of injury to the ear canal and eardrum.

Living foreign bodies (bugs, cockroaches, midges, flies, etc.)

Symptoms and course: A living foreign body of the ear moves in the external auditory canal, which gives the patient a lot of unpleasant sensations: pain, tickling, noise in the ear. Constantly moving, a living foreign body of the ear leads to irritation of the vagus nerve receptors located in the ear canal with the occurrence of dizziness and reflex vomiting. Children may have seizures. Some insects are capable of releasing specific chemicals that irritate the thin skin of the ear canal and cause necrosis.

The diagnosis is confirmed by an otoscopy.

First aid and treatment: Unbearable sensations accompanying the foreign body of the ear of living nature make the patient immediately consult a doctor. As a rule, a living foreign body of the ear is first sacrificed and then removed. To quickly get rid of unpleasant symptoms, the patient can independently immobilize the insect by dropping ethyl alcohol, liquid paraffin or sunflower oil into the ear.It is better to entrust the subsequent removal of the foreign body of the ear to the otolaryngologist. Due to a quick visit to the doctor, a patient with a living foreign body of the ear usually does not have time to develop inflammatory complications, and the insect is successfully removed by washing the ear, removing it with tweezers or a hook.

Nasal foreign bodies

Nasal foreign bodies, like ear foreign bodies, are most often found in children.

There are two types – living and non-living foreign bodies.

Inanimate – small objects (buttons, beads, peas, seeds, small parts from toys, etc.) often do not cause any pain.

Pieces of food masses can also get stuck in the nasal cavity, which get there through the nasopharynx during vomiting. Sometimes lime and phosphorus salts are deposited around a foreign body that has been in the nasal cavity for a long time, as a result of which a so-called nasal rhinolith stone is formed.

Symptoms and course: Obvious presence of a foreign body in the nose, unilateral difficulty in breathing through the nose and purulent, foul-smelling discharge from one half of the nose, less often nosebleeds.To make a diagnosis, rhinoscopy is performed (examination of the nasal cavity and nasal passages with a rhinoscopic mirror), palpation with a probe and radiography (metal bodies).

First Aid: If you see a foreign body in your child’s nose and it is easy to grasp, try to pull it out with your fingers or with rounded tweezers. If the foreign body cannot be removed, ask the child to blow his nose.

Treatment: If the foreign body cannot be removed by blowing it out, remove it with a blunt hook.Flat foreign bodies (coins, matches, paper, etc.) can be removed with tweezers. One should not be fooled by the ease of removal of seemingly closely spaced round foreign bodies with tweezers or forceps, as they often slip out and push further. Large rhinoliths should be crushed with nasal forceps and removed in parts before extraction.

If the foreign body cannot be easily removed from the nose, see a doctor or take the child to a specialized ward.

What not to do: Do not try to remove a foreign body from the nose if you cannot see it or if it is difficult to grasp: any attempts will only contribute to further pushing the foreign body into the depth of the nasal passage and there is a danger of the foreign body getting into the respiratory path, there is also a possibility of injury to the nasal mucosa.

Pharyngeal foreign bodies

Foreign bodies of the pharynx, as a rule, get in with food (fish bones, husks from cereals, pieces of wood, etc.), less often pins, nails, needles, glass shards get stuck. If chewed insufficiently and swallowed too quickly, large pieces of food can become lodged over the esophagus, blocking the larynx and causing asphyxiation. Conversation, laughter while eating contribute to the ingress of foreign bodies. Most often, sharp foreign bodies get stuck in the area of the pharynx, tonsils and the root of the tongue, less often in other parts of the pharynx.

Symptoms and course: Feeling of something foreign in the throat, pain, tingling when swallowing, difficulty swallowing, drooling.With large foreign bodies, speech and breathing are impaired. The diagnosis is made on the basis of complaints and examination of the pharynx, palpation (small, deeply embedded foreign bodies), X-ray examination (metal objects) or using a special laryngeal mirror.

Treatment: It is necessary to contact the nearest hospital as soon as possible in order to receive qualified and high-quality ENT care: taking anamnesis, examining the oral cavity and pharynx using instruments.If a foreign body is found – removal.

It should be noted that with prolonged presence of a foreign body, local inflammation develops, possibly suppuration.

What not to do: If a foreign body gets in, it is strictly forbidden to eat stale bread, crackers, crusts, as this will lead to greater injury to the mucous membrane and complicate the diagnosis, since only mucosal injuries are visible when examining the pharynx. Scratches and abrasions of the mucous membrane can simulate the presence of a foreign body for a long time.

Head of ENT department

branch

Tambov regional

Children’s Clinical Hospital Ivanov Oleg Viktorovich

Doctor – otolaryngologist

Tambov regional

Children’s Clinical Hospital Igor Ovsyannikov

Foreign bodies in the ear: causes, symptoms and removal

A foreign body can be any object, an insect or other living creature, a piece of cotton wool, a sulfur plug, a part of a hearing aid, plant seeds, etc.The presence of a foreign body in the ear is accompanied by pain in the ear, noise in the head, feeling of pressure, hearing loss, in some cases, dizziness and vomiting may occur. With a long-term presence of a foreign body in the ear, an inflammatory process develops, which can lead to serious complications, therefore it is very important to diagnose and eliminate the problem in a timely manner. Various factors can cause a foreign body to enter the ear. In childhood, this is most often the deliberate placement of fragments of toys in the ear canal, therefore, parents are obliged to closely monitor the child, not to give small children collapsible toys with small parts and other small objects.

For adult patients, it is common for foreign bodies to accidentally enter the ear. Often, the cause of a foreign body can be an injury, as a result of which sand, earth, a piece of glass, a bullet, a fragment of an exploded projectile, etc. enter the ear. A foreign body in the ear can be both relatively safe and quite life-threatening for the patient. The level of risk of complications depends on the type of foreign body, its location and the timeliness of medical care provided.

Classification of foreign bodies of the ear

In medical practice, the classification of foreign bodies is used by the mechanism of occurrence and by the nature of the foreign body. Endogenous and exogenous foreign bodies are distinguished regarding the mechanism of occurrence. Endogenous foreign bodies form directly in the ear, while exogenous foreign bodies enter the ear from the external environment. The bulk of foreign bodies are exogenous, but according to statistics, endogenous foreign bodies are also quite common, they are sulfur plugs formed in the ear canal.

The classification of foreign bodies by nature implies the division of all foreign bodies into two large groups: living (mobile) and inanimate (inert). Living foreign bodies of the ear include various types of insects that enter the air or by entering the patient’s ear when he is sleeping or lying in the grass, as well as larvae and leeches that enter the ear canal while swimming in water. Non-living foreign bodies can be household items (button, battery, bead, piece of foam, paper, cotton wool, small parts of the designer and toys), as well as pebbles, plant seeds, sand, etc.

Inanimate foreign body: symptoms, diagnosis, removal

With a non-living foreign body in the ear, sometimes the patient may not feel any symptoms, this happens if a small and smooth object enters the ear that does not injure the skin of the ear canal and the eardrum. Foreign bodies of a larger size block the passage of sound waves through the auditory tube, causing hearing loss, in which case patients complain of congestion in the ear.

Foreign body symptoms

If the foreign body has sharp protrusions, trauma to the skin of the external auditory canal and the tympanic membrane often occurs, after which bloody discharge may appear from the ear, while the patient feels pain in the ear.A pointed foreign body can perforate the eardrum, which is fraught with the development of acute otitis media, which can turn into a purulent form.

Any foreign body has an irritating property in relation to the skin of the external auditory canal, which is manifested by hypersecretion of sulfur and sweat glands. The increased humidity in the ear canal contributes to the swelling of some foreign bodies (beans, corn, peas) and the complete closure of the lumen of the ear canal, which provokes discomfort, pain, a feeling of fullness in the ear and a significant decrease in hearing.With a significant increase in the foreign body, the tissues in the ear are compressed, which entails their necrosis. Such a foreign body wedges into the ear canal, making it difficult to remove. A battery trapped in the ear is especially dangerous for the patient; it has the ability to conduct electric current in a humid environment and kill nearby tissues.

In case of untimely removal of the foreign body of the ear, an inflammatory reaction develops. Patients experience hearing impairment, pain in the ear, and mucopurulent discharge from the external auditory canal is released.In severe cases, the body temperature rises, there is a headache, the general condition of the patient worsens. Edema of the ear canal develops, which further impedes the removal of a foreign body.

Diagnostics

In large sizes, the foreign body can be seen with the naked eye. During the examination, the otorhinolaryngologist uses a funnel or otoscope, to improve visibility in adult patients and adolescents, the auricle is pulled down and back with one hand, and when examining small children, the auricle is shifted down and back.If you do not seek help in a timely manner, edema increases in the ear canal, which complicates the visualization and removal of a foreign body. If the inflammatory process is purulent in nature, a bacteriological analysis of the discharge is performed in order to determine the sensitivity to antibacterial drugs for their correct prescription.

If a foreign object enters the ear through trauma, the patient undergoes an X-ray examination of the skull. An important point in the diagnosis of a foreign body of the ear is differential diagnosis, the purpose of which will be to exclude a tumor, perforation of the membrane, damage to the external auditory canal and hematoma.

Treatment

It is very important to remove the foreign body as soon as possible before the inflammatory reaction begins to develop. It is highly undesirable to try to remove a foreign body on your own, because in this way you can only harm your own body.

Procedure for removing a foreign body from the ear

If there is no suspicion of perforation of the tympanic membrane, which is determined during examination and otoscopy, removal of a foreign body in an ENT office begins with washing the ear canal.Rinsing is performed with distilled water heated to 34-360C, using a Janet syringe (water is drawn into the syringe and rinsing is performed under low pressure). After washing, the doctor removes the remaining water in the ear canal with a turunda. In addition to perforating the membrane, flushing is prohibited in the presence of a foreign body in the form of a battery or flat, thin objects that can move deeper under the pressure of water.

Also, the removal of a foreign body of the ear can be carried out using a thin ear hook, the bent end of which, with a slow, smooth movement, is pulled over the foreign body, thus picking it up and then pulling it out.When removing swollen seeds, the ear is instilled with 96% ethyl alcohol, which promotes dehydration and reduces the size of the foreign body.

In most cases, removal of a foreign body from the ear does not require the use of anesthetics, but if necessary, this option is possible. For anesthesia, during the removal of a foreign body, an adult patient is used local anesthetic drugs (ultracaine, lidocaine), if anesthesia is necessary for young children, the method of general sedation is used.A very important step in removing a foreign body from the ear is the subsequent, after removal of the object, a thorough examination of the skin of the ear canal and tympanic membrane for damage and perforation (this is important to determine the correct tactics for further treatment). After examination, a turunda with calendula tincture and Levomekol ointment is placed in the ear, it is recommended to put an antibacterial ointment on turunda in the ear for the next 3-4 days, as well as re-examination the next day. In the case of complications that develop, in the presence of significant edema and heavily wedged foreign bodies, surgical operations are performed by means of a small incision behind the auricle.

Living foreign body of the ear: symptoms, diagnosis, removal

The ingress of a living foreign body into the ear provokes very unpleasant and painful sensations, tickling and noise in the ear. Continuous movement of a foreign body in the ear irritates the endings of the vagus nerve, thereby causing dizziness and reflex vomiting. Children sometimes have seizures.

Some species of insects are characterized by the secretion of toxic substances that cause necrosis of the tissues of the ear canal.The unbearable discomfort caused by a living foreign body in the ear makes you immediately consult a specialist. To relieve discomfort, before the patient is transported to the clinic, it is recommended to drip the ear with an oil solution, but this should only be done if you are sure that the cause of the discomfort is a living foreign body. The diagnosis in the clinic is made on the basis of the ENT doctor’s examination of the ear canal using a funnel and a reflector, in some cases an otoscope is used.

Before removal of a living foreign body, it is usually sacrificed. Immediate medical attention minimizes the risk of complications.

Sulfur plug: symptoms, diagnosis, removal

As a rule, sulfur plugs are formed due to hypersecretion of earwax, difficulty in excreting it outward due to the curvature of the ear canal or its anatomical narrowness. Frequent cleaning of the ear canal with hygienic cotton swabs also provokes increased sulfur production, and improper cleaning contributes to pushing sulfur into the depths and accumulating it there in the form of a sulfur plug.

The clinical manifestation of sulfur plug can be ear congestion, hearing loss, and sometimes a feeling of fullness. When the sulfur plug comes into contact with the tympanic membrane, noise occurs in the ear.

Diagnostics of sulfur plugs

Sulfur plugs are diagnosed by examination and otoscopy. Often, sulfur plugs are formed due to fungal lesions of the skin of the external auditory canal and the tympanic membrane, such cases are especially dangerous and unpleasant, since inflammation, and sometimes perforation, is often hidden under the sulfur plug.After removing such a sulfur plug, a long period of treatment with antifungal drugs and follow-up follow.

Treatment of sulfur plugs

Removal of sulfur plugs in most cases is done by washing with a stream of distilled water under low pressure. If the plug is large and dense, the patient is advised to instill a few drops of 3% hydrogen peroxide into the external auditory canal for several days, and then come for a second appointment to rinse the ear.Sometimes ear forceps or hooks are used to remove wax plugs. After removing the sulfur plug, the auditory canal and tympanic membrane are examined, and then alcohol turunda is placed in the lumen of the ear canal. For the next 2-3 days, the patient is recommended to put alcohol turundas in the ear. If the painful sensations do not stop, it is worth contacting the ENT doctor again to exclude inflammatory processes in the ear.

Removal of a foreign body from the ear in Moscow from 2970 rubles.

Removal of a foreign body from the ear – medical manipulation in which the otorhinolaryngologist removes a foreign object from the cavity of the ear canal.

If an insect enters the ear, urgent removal is carried out. If the inflammatory process has begun, drug therapy is used.

Removal is performed in the following ways:

surgical intervention;
removal with special tweezers;
application of Hartmann instruments;
leaching with medicinal solutions.

Main indications

The main indication for removing a foreign object is its direct hit into the ear cavity. The presence of a foreign body can be suspected by the following signs:

development of hearing loss;
a feeling of stuffiness in the ear;
discomfort, pain (usually occurs abruptly).

How to prepare for the procedure

First of all, the ENT doctor collects the patient’s history, as well as a physical examination.If it is not possible to see a foreign object with the naked eye, the doctor uses otoscopy (a light source and a frontal reflector are used). In some cases, local or general anesthesia is used.

Features of the procedure

If an insect enters the ear without damaging the eardrum, the otolaryngologist pours in a certain amount of 70% alcohol, preheated to 37 degrees. Then the alcohol solution is washed off with a special syringe (Janet).Janet’s syringe is also used when it is necessary to flush out oval foreign bodies with a smooth structure.

In case of the formation of an epidermal plug in the ear, instillation is carried out with the same alcohol solution, to remove it, forceps for the ear cavity and a hook are used.

If the object falls into the narrowed part of the auricle, surgical intervention is prescribed – the surgeon separates part of the posterior wall of the ear space, removes the foreign body and sutures.

Removing the sulfur plug requires some preparation. 5 days before the manipulation, the patient injects an alcohol solution and carries out washing with warm boiled water. At the appointment with the otolaryngologist, the plug is removed using forceps and a special hook.

If it is necessary to remove objects that have the ability to swell (peas, various seeds), dehydration (dehydration) is carried out in advance with 3% boric alcohol. Then the specialist removes the object with an otorhinolaryngological hook (using a Hartmann set).It is possible to use anesthetic drugs, since the manipulation causes severe pain.

The elimination of foreign bodies in children takes place, as a rule, under local anesthesia. In some cases, the child must be immobilized – the nurse wraps him in a sheet and holds him. This is a forced measure, applied to children prone to neurasthenia.

After the procedure, the doctor examines the ear cavity to exclude injury, possibly an X-ray examination.

Foreign body of the ear – causes, symptoms, diagnosis and treatment

Foreign body of the ear – a foreign object located in the external auditory canal or trapped in the middle or inner ear cavity. An ear foreign body can be any small household item or pebble, toy, piece of paper, plasticine, cotton wool, wood chip or stick, plant seeds, insect or other living organism, part of the hearing aid, accumulation of earwax.A foreign body of the ear is manifested by congestion and pain in the ear, hearing loss, a feeling of pressure in the ear, and sometimes dizziness and vomiting. Diagnosis of a foreign body of the ear is carried out using otoscopy. Removal of a foreign body of the ear, depending on its size and shape, is carried out by washing, instrumental method or by surgical intervention.

General

Like the foreign bodies of the pharynx and nose, the foreign body of the ear is most often diagnosed in children.During the game, the child himself introduces a foreign object into the external auditory canal. It’s good if he tells his parents about it. Otherwise, an object in the ear for a long time leads to the development of inflammation. In adults, a foreign body of the ear occurs at random. Often, the cause of a foreign body of the ear is various kinds of injuries, as a result of which earth, sand, a piece of glass, a fragment of an exploded shell, a bullet, etc. can get into the ear. In this case, the foreign body of the ear can be located not only in the external auditory canal, but also in the tympanic cavity or in the inner ear.Elderly people with severe hearing loss may have batteries and hearing aid parts with a foreign body in the ear.

Foreign body of the ear

Classification

According to the mechanism of occurrence, otolaryngology divides the foreign bodies of the ear into exogenous and endogenous. An exogenous foreign body of the ear enters it from the external environment, and an endogenous foreign body is formed directly in the ear. Most foreign bodies in the ear are of exogenous origin. Endogenous foreign bodies include sulfur plugs.

By their nature, foreign bodies of the ear are divided into 2 large groups: inanimate (inert) and living (mobile). Non-living foreign bodies of the ear include small pebbles, sand, seeds of various plants, household items (buttons, beads, batteries, small toys and construction kit parts, pieces of paper, styrofoam, cotton wool, etc.) A living foreign body of the ear can be an insect accidentally caught from the air or crawling into the ear while the person was sleeping or lying on the grass; a leech or larva from an open reservoir that has penetrated the ear canal while swimming.Free-lying and fixed foreign bodies of the ear are also distinguished.

Non-living foreign body of the ear: symptoms, diagnosis, removal

Foreign body of the ear of non-living nature in some cases may not cause any discomfort in the patient. This usually applies to small and smooth items. A larger foreign body in the ear, obstructing the passage of a sound wave through the auditory tube, causes hearing loss and a feeling of ear congestion. An ear foreign body with sharp protrusions can injure the skin of the ear canal or eardrum, resulting in pain and bleeding from the ear.It is capable of perforating the eardrum. As a result of perforation, an infection can enter the middle ear cavity, leading to the appearance of otitis media.

The foreign body of the ear, to one degree or another, irritates the skin of the external auditory canal, stimulating the secretory activity of the sulfur and sweat glands. As a result of increased humidity, ear foreign bodies such as peas, corn and beans swell and increase in volume over time. At the same time, they completely block the lumen of the ear canal, which is accompanied by a significant hearing loss, a feeling of fullness in the ear and pain.Reaching a considerable size, such a foreign body of the ear squeezes the tissues inside the ear canal, causing their necrosis. It turns out to be wedged into the ear canal, which makes it much more difficult to remove. Batteries trapped in the ear are very dangerous. By conducting electrical current in a humid environment, they can cause necrosis of the ear canal skin.

Timely not removed foreign body of the ear leads to the development of an inflammatory reaction. In such cases, there is the appearance of pain in the ear, the discharge of mucopurulent discharge from it, and hearing impairment.With severe inflammation, an increase in body temperature, headache is possible. The inflammatory reaction is accompanied by edema, which reduces the lumen of the ear canal, which greatly complicates the removal of a foreign body from the ear.

A foreign body of the ear of an inanimate nature is often detected by a simple examination of the external auditory canal. For better viewing of the ear canal in an adult patient or an older child, the otolaryngologist pulls the auricle up and back with one hand.In young children, the auricle is displaced down and back. If the patient did not immediately seek help, then the inflammation and edema that developed in the ear canal interfere with visualization of the foreign body of the ear and can hide it. In such cases, otoscopy and microotoscopy are necessary for diagnosis. In the presence of secretions, their microscopy and bacteriological examination are carried out to determine the type of microorganisms that caused the inflammatory process and their sensitivity to antibiotics. If a foreign object has entered the ear as a result of an injury, an X-ray of the skull is additionally prescribed.An ear foreign body should be differentiated from ear tumors, damage to the external auditory canal, perforation of the tympanic membrane, otitis externa, and hematoma.

Removal of the ear foreign body should be performed as soon as possible before the ear canal develops an inflammatory reaction or swelling of hygroscopic foreign objects. You should not try to remove the foreign body of the ear yourself. Such attempts can lead to injury to the skin of the ear canal, damage and perforation of the tympanic membrane, secondary infection.

The easiest way to remove a foreign body from the ear is to rinse. It is carried out with water heated to body temperature. The doctor draws water into a syringe with a cannula, inserts the end of the cannula into the ear canal and rinses under a slight pressure. If necessary, the procedure is repeated several times. After rinsing, the remaining fluid in the ear is removed with a turunda. Washing the ear is contraindicated in the presence of batteries, thin and flat foreign bodies, which can be carried into the ear canal by the current of water, as well as in the case of perforation of the eardrum.

Removal of an ear foreign body can be carried out with a thin ear hook inserted behind the foreign object in such a way as to grab and pull it out of the ear canal. To avoid injury to the ear canal and perforation of the tympanic membrane, manipulation should be carried out under constant visual control. Before removing the seeds swollen from moisture, 96% ethyl alcohol is instilled into the ear, which, due to its dehydration effect, helps to reduce the volume of a foreign body.

In the absence of severe pain syndrome, removal of a foreign body of the ear can be performed without anesthesia, in other cases, local anesthesia is required, and in young children, general sedation. After removing the foreign body of the ear, a thorough examination of the external auditory canal is performed for damage and inflammatory areas. If such are found, the skin is treated with a solution of boric acid, in addition, an ear antibacterial ointment is prescribed.

In case of severe inflammatory changes and swelling of the ear canal, the removal of the foreign body of the ear is postponed for several days, during which a combined anti-inflammatory, anti-edema and antibacterial treatment is carried out.The abatement of inflammation increases the chances of a successful removal of a foreign object.

Surgical removal of the foreign body of the ear is performed if it is impossible to remove it through the external auditory canal. The operation is performed through a small incision behind the auricle.

Living foreign body of the ear: symptoms, diagnosis, removal

Living foreign body of the ear moves in the external auditory canal, which gives the patient a lot of unpleasant sensations: pain, tickling, noise in the ear.Constantly moving, a living foreign body of the ear leads to irritation of the vagus nerve receptors located in the ear canal with the occurrence of dizziness and reflex vomiting. Children may have seizures. Some insects are capable of releasing specific chemicals that irritate the thin skin of the ear canal and cause necrosis.

Unbearable sensations accompanying the foreign body of the ear of living nature make the patient immediately consult a doctor.The diagnosis is confirmed by an otoscopy.

As a rule, a living foreign body of the ear is first sacrificed and then removed. To quickly get rid of unpleasant symptoms, the patient can independently immobilize the insect by dropping ethyl alcohol, liquid paraffin or sunflower oil into the ear. It is better to entrust the subsequent removal of the foreign body of the ear to the otolaryngologist. Due to a quick visit to the doctor, a patient with a living foreign body of the ear usually does not have time to develop inflammatory complications and the insect is successfully removed by washing the ear, removing it with tweezers or a hook.

Sulfur plug: symptoms, diagnosis, removal

The formation of sulfur plug can occur due to increased production of earwax, difficulty in its discharge due to anatomical narrowness or curvature of the external auditory canal. Improper ear hygiene also contributes to the development of wax plugs. For example, the habit of cleaning your ears by inserting an ear stick into the ear canal can push the ear wax into the ear and cause a waxy plug to form.

A foreign body of the ear in the form of a sulfur plug is manifested mainly by a feeling of ear congestion and hearing loss.There may be a feeling of increased pressure in the ear canal. If the cerumen comes into contact with the eardrum, a noise in the ear occurs. Sulfur plugs are diagnosed by examining the external auditory canal and otoscopy.

Removal of the wax plug, like most other foreign bodies of the ear, is performed primarily by rinsing. Previously, the patient is recommended to instill hydrogen peroxide in the ear for several days, which softens the sulfur plug and facilitates its removal. If the irrigation is ineffective, instrumental removal of the sulfur plug using ear forceps or a special hook is indicated.

Foreign body – Otorhinolaryngology

Foreign bodies can cause pain due to pressure on nerve formations, lead to bleeding (pressure ulcer of the vessel), perforation, but can remain in the body for many years without complications.

In everyday life, foreign bodies are more common in children who swallow, inhale, stick all kinds of objects into the nose and ear. Adults accidentally swallow meat and fish bones, sometimes (in a dream, in a fainting state) dentures.

From the respiratory tract of the pharynx and esophagus, foreign bodies are removed mainly with an endoscope . In the stomach and intestines, a foreign body, even with sharp edges, often moves safely during peristaltic contractions and leaves in a natural way; in these cases, prescribe enveloping food (porridge, mashed potatoes, jelly, milk) and observe (radiographically) the progress of the object.

A special category is made up of foreign bodies introduced into the body for therapeutic purposes for a certain period (a nail for knocking together bone fragments in fractures, a pacemaker of the heart in case of its blockade) or forever (vascular prosthesis, heart valve).Such foreign bodies should not irritate living tissue. The surfaces of the prostheses in contact with blood must be perfectly smooth so as not to cause blood clots.

Ingestion of a foreign body in the eye and ear.

A foreign body (grain of sand, midges, etc.) that has got on the mucous membrane of the eyelid or eyeball must be carefully removed. For this, the victim is forced to look up and the edge of the lower eyelid is pulled down with the thumb. To inspect the mucous membrane of the upper eyelid, the victim must look down, while the skin of the eyelid is pulled up.Having found a speck, it is carefully removed with a damp cotton swab or the tip of a clean handkerchief.

If for some reason the speck is not removed or is in the cornea, do not try to remove it at all costs – you can injure the cornea. It is necessary to rinse the eye with a pipette with a solution of boric acid (half a teaspoon per glass of warm water) and not tightly bandage it. Do not rub your eyes or lick a speck.

If an insect enters the ear, the victim lies on his side, and a little vegetable or other oil is instilled into his ear canal.After a minute, he should turn over on the other side and lie for several minutes until the foreign body comes out along with the oil. If a foreign body remains in the ear canal, you should not remove it yourself, it is better to consult a doctor.

Sand from the ear is removed by washing with hydrogen peroxide using a small rubber bulb. Under no circumstances should you try to remove a foreign body from the ear with hairpins, needles, matches!

Help with foreign body getting into the nose.

Nasal foreign bodies are more common in children who themselves stuff small objects into their noses (balls, beads, berries, buttons, etc.). Often this leads to the development of an inflammatory process, which is manifested by nasal congestion, difficulty in nasal breathing, and the appearance of nasal discharge with an unpleasant odor.

Assistance. It is necessary to ask the child to blow his nose, pressing the healthy half of the nose with his fingers. If after this the foreign body remains in place, you should immediately consult an otolaryngologist (ENT).

Attention! It is unacceptable to attempt to remove a foreign body from the nose by yourself. This can damage the nasal mucosa, the nasal septum, stop breathing or push the foreign body further into the airway, and this is already life-threatening for the child.

Ingress of a foreign body into the respiratory tract

Most often, foreign bodies enter the respiratory tract when talking, while eating or in inflammatory diseases of the larynx.

Closing the lumen of the trachea, they stop the access of air to the lungs: breathing stops, then the heart. When a foreign body enters the larynx, it causes a coughing fit, during which it can jump out.

If this does not happen, a feeling of suffocation appears, which can lead to loss of consciousness due to cessation of breathing and heart.

Assistance:

If the victim is conscious, it is necessary to stand behind him and ask to tilt the torso forward at an angle of 30-45 °, with the palm not strongly, but sharply 2-3 times hit him between the shoulder blades.
If this does not help, then a different, more effective method should be used.
It is necessary to approach the victim from the back, clasp him with your hands so that the hands folded “in the lock” are on the midline of the abdomen (on its upper part – the epigastric region), sharply and strongly press 2-3 times back and up.
This removes the foreign body from the respiratory tract. If there is no effect, the manipulation should be repeated.
If the victim is unconscious, he should be laid with his stomach on a bent knee, with his head lowered as far as possible.Hit 2-3 times with the palm between the shoulder blades quite sharply, but not very hard. If there is no effect, the manipulation is repeated.

Attention! The success in providing assistance to the victim directly depends on the competent actions of the person providing assistance. The decisive factor here is the time factor.

The sooner help is started, the more likely the victim is to revive.

Therefore, at the same time as the start of first aid, it is necessary to call a doctor for the earliest possible provision of qualified medical care
.

90,000 Alien Objects in ENT Organs – Into-Sana

What are foreign bodies in the external auditory canal? These can be small objects that children easily manage to place in their ear (fragments of toys, pebbles, beads). Insects can also accidentally get into the ear. Foreign objects in the ears can cause pain, and if the eardrum is damaged, bleeding. Hearing loss is common.Some foreign bodies in the ear may not cause any symptoms for a long time. For example, there were cases when, during the examination of schoolchildren, especially junior grades, pieces of paper, fragments of seeds were found in their ears.

It should be remembered that self-removal of a foreign body from the ear can lead to its pushing deep into the external auditory canal, as well as injury to the eardrum. Therefore, you should not make an attempt to remove a foreign body at home, but it is better to immediately seek help from an ENT doctor.

If an insect enters the ear, its movements may cause discomfort and pain for the patient. In this case, before visiting the ENT doctor, you can drip alcohol diluted with boiled water in a 1: 1 ratio into the ear. This will immobilize the insect, after which the doctor can easily remove it.

Nasal foreign bodies are found mainly in children. Very often, children strive to put fruit bones, coins, wheels from their favorite cars, pebbles in their nose. The presence of a foreign body in the nasal cavity can lead to difficulty in nasal breathing, the appearance of bloody discharge.Long-term presence of a foreign body in the nose can provoke the development of an inflammatory process. If a foreign body is still in the nasal cavity of the child, then to remove it, you need to blow your nose. The healthy half of the nose should be clamped. If this method is ineffective, it is necessary to urgently consult an ENT doctor.

Foreign bodies of the lower respiratory tract are fraught with life-threatening consequences. The most common symptoms are coughing and choking. If a large foreign body enters the larynx, it can close the glottis and cause death.In such situations, every second is important, so everyone should know the basics of first aid.

First aid in case of inhalation of a foreign body

– The child is immediately turned head down (the infant can be turned head down, taking him by the legs) and tapped with an open palm on the back at the level of the shoulder blades.

– Adult tilt over the back of a chair, sofa or your thigh and hit several times with an open palm between the shoulder blades.

The most effective, but at the same time, the most dangerous method of extracting foreign bodies, you could repeatedly observe in many films. This is the so-called, “Heimlich way” . The principle of this method is that with a sharp push under the diaphragm, air is pushed out of the lungs, which displaces the foreign body. The danger is that impacts below the diaphragm or strong squeezing of this area with your hands can lead to reflex cardiac arrest. For this reason, it is important to perform this technique correctly.

Procedure for helping a choking person according to the Heimlich method in a standing position

It is necessary to stand behind the victim’s back, wrap your arms around him.
Squeeze one hand into a fist and, with the side where the thumb is, put it on the victim’s stomach at the level between the navel and the costal arches (in the so-called epigastric region of the abdomen).
The palm of the other hand is placed on top of the fist, with a quick push upward the fist is pressed into the stomach.In this case, the arms should be sharply bent at the elbows, but the victim’s chest should not be squeezed.
If necessary, repeat the reception several times until the airways are free.

Even if you managed to remove a foreign body on your own, in any case it is necessary to consult a doctor, since the possibility of damage to the mucous membrane is possible.

There are simple but important rules, following which we minimize the risk of foreign body getting into the respiratory tract.

Rule one: Do not eat on the go, in transport (for example, sudden braking in transport can lead to food getting into the wrong throat).

Rule two: Laughing and talking with a full mouth, you forget not only about the rules of good manners, but also about your own safety.

Rule Three: Do not use your mouth to hold foreign objects. Of course, it is very convenient, by nailing a picture to the wall, to fix an additional nail in your teeth, but think about the fact that a nail caught in the respiratory tract will not allow you to fully enjoy the masterpiece.

Rule four: If you see an object in a child that can easily fit in his mouth, be sure to take it away. Keep small objects out of the reach of your child.

In addition to all of the above, I would like to additionally dwell on the problem of such foreign bodies as fish bones. What to do in such cases? Is it possible to get the fishbone out of the throat on your own? Should you listen to “grandmother’s” and Internet advice?

Let’s try to figure out their effectiveness together.

1. The most common advice, which is used by about 90% of patients before contacting an ENT doctor, is to swallow a crust of bread or crackers for “better pushing the bone”. You shouldn’t do that! This leads to the fact that the bone breaks and sinks even deeper into soft tissues, making it difficult to detect and retrieve.

2. The opinion that when vomiting is provoked, the vomit will carry away the fish bone. However, as a rule, vomit comes out, and the bone remains in place.