ENT: Foreign body in ear

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Foreign body in ear
 Presence of foreign body inside the ear canal
Incidence:
*    common in children
*    patients with schizophrenia
*    in person who are bored
Two types : living/ non-living
Non living

Children may insert variety of fb in the ear        
Pieces of chalk
grains
Piece of paper
Stone
Piece of pencil  
Adult may present with
Seeds        
Match stick
Wood / metal

Living

Flying insects like mosquito, flies and small cockroach
 maggots in the ear canal
 flies may be attracted to foul smelling discharges and lay eggs and which hatch out in to larvae which is known as maggot 

Clinical manifestations:
depends upon the type of foreign body    
Coughing due to compression of vagus nerves
Conductive hearing loss in the affected ear        
Otalgia
intense irritation
Sensation of fullness
Tinnitus

Management: non living
Forceps removal

Soft and irregular foreign bodies are removed by this method 
By using crocodile forceps
Syringing: most of seed grains and smooth objects removed by this method
Microscpic removal with special equipment: smooth and hard object like steel balls should be removed by general anaesthesia and an operating microscope
Suction: by low suction pressure we can remove the foreign material from the ear canal

Postural approach: used when foreign body impacted in the deep meatus:
by this method it can be push in to middle ear

Management: living
Kill insects by instilling oil (household remedy) spirit
Chloroform water
Once killed the insects, it can be remove by any method same as for nonliving management

Management: maggots
*    instilling chloroform water
*    later removed by forceps
*    usually such patient have discharging ears with perforation of tympanic membrane so syringing may not be advisable


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notes.nursium.com: ENT: Foreign body in ear
ENT: Foreign body in ear
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