Trick of the trade: Ear foreign body extraction

Trick of the trade: Ear foreign body extraction

2016-11-15T22:08:19+00:00

BeadsA 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!

Dermabond Ear FB

 

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

Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

Latest posts by Michelle Lin, MD (see all)

  • I have also used “mini-suction” (with due credit to Whit Fisher @ BI in NY) for a spherical earring in a a teenager. Totally painless!

    http://procedurettes.com/Procedurettes/index.html.html

    And for pediatric patients with foreign bodies in the nose, with a few exceptions the trick of occluding the opposite nostril and having the mother breath forcefully into the child’s mouth is always a crowd-pleaser. There’s nothing like going from a crying child and anxious parents to everyone smiling and quickly leaving the department in less than 10 minutes.

  • Good post…well done. You hit it on the head–the kid has to be cooperative and then this procedure works. I was going to write a post on removing ear wax (my favorite thing to do! LOL) but I’m gonna pass now…WEll done!

  • StorytellERdoc: Wow, ear wax – really? I usually hate ear FBs because you run exactly into the problem of the squirmy child. Usually much less success than nasal FBs.

  • Menelaus: Yes, I’ve seen Whit’s great collection of videos. Thanks for the tip on mini-suction.

    As for the nasal FB trick you mention, it’s usually more messy than expected. Lots of snot comes out along with the FB. Make sure you warn mom (and those nearby)!

  • This is really a good post..
    I am impressed..

    Thanks
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