Trick of the trade: Ear foreign body extraction

A 6-year old boy has placed a hard bead in his ear and presents to the ED for care. How do you remove this foreign body as painlessly as possible? You can just barely see the edge of the bead by just looking at the external ear.

By experience, you know that mini-Alligator clips and forceps will not be able to sufficiently grab the edges of the bead. Additionally it may push the bead in even further.

Trick of the Trade

Tissue adhesive glue to the rescue!

Apply the glue gently to a long Q-tip’s wooden end. Immediately adhere the stick to the bead, being careful not to touch the external ear canal. This should be a painless procedure. In fact, I was showing the child some animation movies during this part of the procedure. After waiting 20-30 seconds to let the glue dry, my resident gently rotated the bead to loosen the bead from the canal edges. Then like magic, he pulled the bead out with only a little “ouch” voiced by an otherwise calm child.

Just as equally entertaining was the pediatric resident doing a little happy dance. Wish I had gotten a photo of that.

NOTE: This technique should only be reserved for the child who can stay still and for hard-surface objects. For instance, it won’t work on organic products such as peas, corn, or cockroaches.

CAUTION (added 9/12/13): Do not apply too much tissue adhesive glue because it may drip into the canal and inadvertently stick the bead to the ear canal.

REFERENCE

1. McLaughlin R, Ullah R, Heylings D. Comparative prospective study of foreign body removal from external auditory canals of cadavers with right angle hook or cyanoacrylate glue. Emerg Med J. 2002 Jan;19(1):43-5. PubMed PMID: 11777871
2. Pride H, Schwab R. A new technique for removing foreign bodies of the external auditory canal. Pediatr Emerg Care. 1989 Jun;5(2):135-6. PubMed PMID: 2748407
3. Thompson MP. Removing objects from the external auditory canal. N Engl J Med. 1984 Dec 20;311(25):1635. PubMed PMID: 6504100

Author information

The post Trick of the trade: Ear foreign body extraction appeared first on ALiEM.