Foreign bodies in the ear

Foreign bodies in the ear and the management

1. Foreign bodies in the ear Mr. Binu Babu M.Sc. Nursing Mrs. Jincy Ealias M.Sc. Nursing

2. A foreign body in the ear is anything that gets stuck in the ear canal other than earwax.

3. Etiology Anything that is inserted in the ear may get stuck and cause an ear foreign body. These things may include; ORGANIC  (living or non living)or INORGANIC NON-LIVING Sponge Eraser Paper Wood Cotton buds

4. LIVING Beans Nuts Worms INORGANIC Bead Metal Stones Plastic toys Button Batery  

5. Clinical manifestations Feeling of something in the ear Ear fullness Trouble in hearing Itching Otalgia (ear ache) Fever Redness Bleeding Thick drainage and a foul odor If the foreign body is an insect, may feel movement or hear buzzing .

6. Diagnostic measures History collection Physical examination Otoscopy Audiometry

7. Management Medical management Treatment will depend on type of foreign body is in the ear. Treatment may also depend on how long and how deep the foreign body is in the ear canal and may include: Pharmacological : Numbing medicine may be put before trying to remove the foreign body. Sedative and pain medicines help to stay comfortable, calm and relaxed. Antibiotics to prevent an infection . The three standard methods for removing foreign bodies are : Irrigation Suction Instrumentation

8. Procedures : If the object can be seen directly, removal may be done using any of the following: Instruments : Forceps (grasper), hook or curette (scraper) may be used to remove the foreign body . Alligator forceps /crocodile forceps can easily graps objects such as cotton wool , paper ,pieces of foam sponge and insects . Ear irrigation : Water that is body temperature is used to force the object out of the canal. Irrigation cannot be used to take out batteries or objects that may expand when they get wet, such as seeds. This procedure also cannot be used on people with an eardrum tear. Suction : A machine that sucks out the object from the ear canal may be used to remove small objects. This procedure uses a small plastic tube that goes in the ear and is connected to the machine. Chemicals : Hydrogen peroxide or acetone may be used to melt dried glue. Acetone may also be used to remove gum or plastic foam. Other : Liquid, such as mineral oil, may be used if the foreign body is a live insect. This is put in the ear to kill the insect first before taking it out. Once the insect is no longer moving, it is taken out whole or in pieces using instruments.

9. Surgical management Surgery is done if the foreign body is very deep. Surgery may also be done to treat ear damage caused by the foreign body. Nursing management Assess for nonverbal signs of ear pain to identify pain. Educate the patient not to put fingers or other objects into the ear. Teach patient how to use topical antibiotics, oral antibiotics, and other medications to promote healing. Instruct patient to report any prolonged symptoms of ear pain, swelling, drainage, or plugged feeling.

10. COMPLICATIONS Ear canal abrasions Bleeding Infection perforation of the tympanic membrane. Otitis externa / otitis media Foreign body granuloma