Clinical Characteristics of External Auditory Canal Foreign Bodies in Children and Adolescents

Abstract

Objectives: Foreign bodies (FBs) in external auditory canal (EAC) can occur at any age but are especially common in children and adolescents. The aims of the study were to evaluate the clinical characteristics of EAC FBs in children and adolescents and to discuss their proper management. Methods: A retrospective medical chart review was performed on patients who were treated for EAC FBs in a tertiary referral center from January 2007 to December 2017. We investigated the parameters of age, sex, type of FB, sedation method, complications, and removal strategy. Results: Of 284 patients, 176 (62.0%) were male. Peak incidences were noted at the ages of 3 to 6 years and 17 to 18 years. The frequently observed FBs were insects, followed by air-gun pellets, cotton balls, marbles, and earrings. Forty-one (14.4%) EAC FBs were removed with the naked eye, while 243 (85.6%) were removed under microscope in the otolaryngology department. Of these patients, 23 (9.5%) were administered sedatives and 1 (4.1%) needed general anesthesia. During or after the removal procedure, 4 (15.5%) patients had complications of EAC abrasion or laceration (42, 14.8%), and tympanic membrane perforation (2, 0.7%). Conclusions: External auditory canal FB showed a distinct characteristic of incidence regarding age, related to removal strategies. Characteristics of FB must be considered for safe removal.

Epidemiological trends and outcomes of children with aural foreign bodies in Singapore

“…Vegetative matter may expand on contact with moisture and lead to high pressures in the enclosed ear canal space. 20 Fortunately, our patients received timely treatment and made good recovery. Live insects in the ear should also be killed by submersion to relieve patient symptoms prior to removal with instruments or irrigation.…”

I’m All Ears: A Population-Based Analysis of Consumer Product Foreign Bodies of the Ear

“…16 Increased numbers of attempts are associated with sedatives and general anesthesia. 17,18 Therefore, ED clinicians should ideally refer the patient to a specialist after the first failed attempt of removal. 19 Otherwise, implementation of an otomicroscope into the ED setting should be considered, due to the instrument's successful rate of removal of complex pediatric ear FB's with few attempts.…”

Foreign Bodies in Children as a Cause of Infection Seen in ENT Practice

“…The usual symptoms created by such a situation are one-sided otorrhoea, earache, blood coming from the ear, auditory impairment, ringing in the ear, coughing, feeling lightheaded or paralysis of facial muscles. In some children, there are no associated symptoms and the foreign body may only come to light when the ear undergoes a routine examination [12][13][14].…”