Management of Foreign Bodies in the Ear: A Retrospective Review of 123 Cases in Nigeria

Abstract

Foreign bodies in the ear are relatively common in emergency medicine. However, attempts at removal made outside the healthcare setting by untrained persons can result in complications of varying degrees. We conducted a 3-year retrospective review of 123 cases of aural foreign bodies at our hospital in Nigeria. Our patient population was made up of 80 males and 43 females, aged 2 to 67 years (mean: 13.2); almost three-fourths of these patients were aged 15 years or younger. Only 40 of them (32.5%) presented to an otolaryngologist within 12 hours of foreign-body insertion. A total of 30 patients (24.4%) had initially undergone removal attempts by a non-otolaryngologist prior to receiving trained ENT care, and 23 of them experienced a total of 41 complications: 17 cases of canal abrasion, laceration, and/or bleeding, 8 cases of otitis externa, 6 cases of tympanic membrane perforation, 5 cases of impaired hearing, 3 cases of chronic suppurative otitis media, and 2 cases of middle ear involvement. Of the 93 patients who were seen by an otolaryngologist initially, only 6 (6.5%) developed a complication: 4 cases of canal abrasion, laceration, and/or bleeding and 2 cases of otitis externa. The difference in overall complication rates between patients treated by otolaryngologists and non-otolaryngologists was statistically significant ( p < 0.001). We conclude that attempts at removal by non-otolaryngologists can result in a high incidence of preventable complications.

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

“…5,7 Indeed, struggling during attempted removal can lead to complications such as perforation of the tympanic membrane and abrasion of EAC skin. 8,9 The aim of this study was to evaluate the clinical characteristics of EAC FBs in children and adolescents and to discuss their proper management.…”

A 5-year review of aural foreign body removal in a Major Victorian Hospital

“…Therefore, it is important to recognize that each unsuccessful attempt can significantly jeopardize the success of subsequent efforts. Repeated attempts not only lead to risk of injuring the EAC and bleeding, but can also compromise a patient's cooperation (5), especially in children who have a variable level of cooperation (1).…”

Retrospektif Analysis of Children Diagnosed with External Auditory Canal Foreign Bodies in Kanuni Sultan Suleyman Training and Research Hospital Otolaryngolgy Clinic: Evalation of 93 Cases

“…(14) yaptığı çalışmada her iki tarafta eşit, Olajide ve ark. (6) yaptığı çalışmada sağ kulakta daha sık görüldüğü bildirilmiştir. Adedeji ve ark.…”

“…(12) yabancı cisimlerin sol kulakta sağa oranla biraz daha fazla, 1 hastada ise her iki kulakta birden görüldüğünü bildirirken, bizim çalışmamızda ise sağ kulakta %54,8, sol kulakta %44,1, her iki kulakta %1,1 oranında görüldüğünü saptadık. Kızlarda daha sık görüldüğünü gösteren çalışmalar olduğu gibi erkeklerde daha sık görüldüğünü gösteren çalışmalar da vardır (3,6,14) . Çalışmamızda, DKY yabancı cisimleri %59,1 oranında kızlarda, %30,9 oranında erkeklerde saptandı.…”

“…(14) en sık kulak çöpü pamuğu (%22) ve böcekler (%18) saptadıklarını, Olajide ve ark. (6) en sık küçük taşlar (%22,8) ve kağıt parçalarına (%16,3) rastladıklarını, Schulze ve ark. (3) en sık boncuk, kağıt parçaları ve mısır taneleri bulduklarını rapor etmişlerdir.…”