Acupressure Bead in the Eustachian Tube

Abstract

In this article, we aim to enlighten practitioners and patients involved with acupressure beads and to contribute to their safer use by reporting a unique case of insidious intrusion of an acupressure bead into the eustachian tube. A metallic object was found in the eustachian tube of a patient while conducting a magnetic resonance imaging (MRI) examination. The object was later confirmed to be an auricular acupressure bead, and was successfully removed by performing a tympanoplasty and a canal wall down mastoidectomy. The bead was assumed to have passed through an existing perforation of the tympanic membrane. According to previously published literature, tympanic membrane perforations exist in ∼1% of the population. Therefore, middle-ear foreign bodies are relatively common occurrences for otolaryngologists. However, metallic objects such as acupressure beads are especially important in the sense that they can cause severe burns during MRI. To avoid potential complications, acupressure-bead practitioners should be aware of the possibility that intrusions through the tympanic membrane could go unnoticed.

Eustachian Tube Foreign Body with Endoscopic-Assisted Surgical Removal

“…Prior to this time, the tip of a dilator was frequently broken off in the eustachian tube during catheterization [2,4]. Since that time, descriptions of eustachian tube foreign bodies have been limited to unfortunate trauma after assault [7], an acupuncture bead [8], and a similar metal slag from welding [6].…”

Adverse event associated with auriculotherapy

“…Foreign bodies in the middle ear are a relatively common occurrence , but there have been few reports of foreign bodies in the middle ear resulting from auriculotherapy, although the prevalence of chronic tympanic membrane perforation is high . We describe two previously reported cases, each of displaced acupressure pellets penetrating the middle ear through a tympanic membrane perforation .…”

“…The possibility that the acupressure pellets in the posterior auricle, which were used to treat high blood pressure, penetrated the tympanic membrane is low, but there is a high possibility that the acupressure pellets in the anterior auricle (for stiff shoulders and sciatica) penetrated the tympanic membrane due to proximity to the earhole. Tympanic membrane perforation is the most likely explanation for the presence of the pellets in the middle ear . Additionally, there have been three cases reported of flying sparks penetrating the middle ear as a result of welding .…”

“…In recent years, auriculotherapy has also been used for insomnia and depression . Many cases have been reported of adverse events associated with general acupuncture and moxibustion , but to our knowledge only two cases have been reported of adverse events associated with auriculotherapy and the corresponding use of acupressure pellets .…”