Organic or decomposing foreign bodies left in the ear canal for a long time can cause local inflammation that may make removal very difficult.
If you are not experienced in removing foreign bodies or if the object to be removed is rather uncommon, it is advisable to consult an ear unit on call for advice on the removal.
Pay attention to aftercare if the skin is broken or infected after removal of the foreign body.
With the exception of button cell batteries and organic foreign bodies, removing a foreign body is not urgent and the patient may be well treated the next working day.
Removal of a foreign body
Most commonly, the foreign body becomes lodged in the narrowing at the boundary of the bony and cartilaginous parts of the ear canal.
Foreign bodies can often be removed with a small forceps, by syringing, with a probe or by suction.
A small suction cap is handy for removing round, hard foreign bodies, such as beads.
Be careful, and choose the best method in advance. The ear canal is highly sensitive and inflexible.
Do not push the foreign body further in.
In the bony external auditory canal or near to the tympanic membrane, do not try to push the removal instrument behind the foreign body.
Do not use syringing for foreign bodies that swell when absorbing moisture.
Ask a nurse or a person accompanying the patient to support the patient's head firmly when removing the foreign body: even a small movement may damage the skin in the ear canal.
If cooperation or the equipment available for removal are insufficient, refer the patient to specialized care.
A foreign body next to the eardrum is most safely removed by irrigation.
An ear hook or an ear probe with a twisted tip must usually be utilized for removal of larger foreign bodies, passing the instrument around and behind the foreign body. With this technique it is possible to pull out the foreign body. The skin of the ear canal is sensitive and the procedure may thus be painful.
A live insect in the ear canal can be killed by dropping alcohol or cooking oil into the ear canal.
If removal seems difficult it can be left to an ENT specialist who may use local or, for children, sometimes even general anaesthesia.
Aftercare
After the removal of a foreign body the skin of the ear canal is often irritated or injured. Spontaneous healing in a few days is the rule.