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Foreign Body, Ear

Foreign Body, Ear is a topic covered in the 5-Minute Emergency Consult.

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  • Foreign bodies (FBs) lodged in the external auditory canal
  • The external auditory canal:
    • Cartilaginous and bony passage lined with periosteum and skin
    • The periosteum is extremely sensitive, making removal a painful procedure:
      • In small children general anesthesia may be required to remove the object
      • FBs usually impact at the junction of the inner end of the cartilaginous portion of the canal or at the isthmus
      • Innervated by the facial, glossopharyngeal, vagus nerves
  • Inanimate foreign objects are often associated with delayed presentations:
    • Children often delay reporting because of fear of punishment
    • Often the FB is an incidental finding in children during an ear exam
  • Physical findings may change due to length of time the object is in the canal
  • Children with cerumen impaction or those with pica are predisposed
  • The location is often the right ear, due to the predominance of right handedness
  • Children and psychiatric patients may insert anything sufficiently small to enter the external auditory canal.
  • Ear FBs are most common in children <8 yr
  • Complications:
    • Canal laceration:
      • Usually caused by repeated attempts to remove a nongraspable object
    • Perforation of tympanic membrane:
      • More likely to result from removal procedure than the FB
    • Otitis externa
    • Malocclusion from erosion into the temporomandibular joint
    • Parapharyngeal abscess
    • Mastoiditis
    • Meningitis
    • Brain abscess
    • Insects may injure the tympanic membrane or canal by stinging, biting, or scratching
    • Button batteries can cause significant destruction due to the strong electrical currents and pressure necrosis
    • Typically, the most damage is caused by negative side of the battery
    • Damage to the facial nerve and ossicles have been reported
  • Symptoms usually resolve within a few days after FB removal


  • Children:
    • Stones
    • Small beads
    • Paper
    • Toys
    • Seeds and popcorn kernels
    • Beans and other food and organic materials
    • Button batteries:
      • Higher risk for necrosis than other FBs
  • Competent adults:
    • Cotton-swab tips
    • Earplugs
    • Insects:
      • Cockroach most common in US
    • Hidden illicit drugs

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Rosen, Peter, et al., editors. "Foreign Body, Ear." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307135/all/Foreign_Body__Ear.
Foreign Body, Ear. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307135/all/Foreign_Body__Ear. Accessed April 25, 2019.
Foreign Body, Ear. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307135/all/Foreign_Body__Ear
Foreign Body, Ear [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307135/all/Foreign_Body__Ear.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Foreign Body, Ear ID - 307135 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307135/all/Foreign_Body__Ear PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -