From the Guidelines
The best way to remove a foreign body from an ear is to seek professional medical help from a healthcare provider, particularly if the object is deeply lodged, causing pain, or if there's drainage or bleeding. When it comes to removing foreign bodies from the ear, it's essential to prioritize methods that minimize the risk of pushing the object deeper or causing damage to the ear canal or eardrum. According to the clinical practice guideline update on earwax (cerumen impaction) 1, manual removal using appropriate instruments and visualization techniques is a preferred method for removing cerumen impaction, and this principle can be applied to foreign body removal as well.
Some key points to consider when removing a foreign body from the ear include:
- Using adequate illumination and visualization instruments, such as a handheld speculum or otoscope, a headlamp or head mirror, or the binocular microscope 1
- Employing gentle and careful techniques to avoid pushing the object deeper or causing damage to the ear canal or eardrum
- Avoiding the use of tweezers, cotton swabs, or other instruments that can push the object deeper or cause damage
- Considering the use of gravity or gentle shaking to help dislodge the object
- Seeking professional medical help if the object is deeply lodged, causing pain, or if there's drainage or bleeding
It's also important to note that certain types of foreign bodies, such as button batteries or sharp items, should never be attempted to be removed at home due to the risk of serious injury. Insects in the ear can be immobilized with a few drops of mineral oil, olive oil, or baby oil, making removal easier 1. However, water-soluble objects like food or paper should not be treated with water or oils, as this can cause swelling. Ultimately, professional removal is always the safest approach to ensure the best outcome and minimize the risk of complications.
From the Research
Removal Techniques
- The use of appropriate instruments and techniques for removing a foreign body from the external auditory canal facilitates the procedure and reduces the risk of complications 2.
- Ear syringing is an effective and easy way of removing most foreign bodies, using a disposable sterile kit with a 20 ml syringe, saline at body temperature, and a 14 or 16 gauge cannula without the needle 3.
- US-guided foreign body removal is a nonsurgical, highly effective technique used to manage symptomatic foreign bodies and should be considered as a first-line treatment procedure 4.
- A cross-needle-guided technique can be used for the quick localization and surgical removal of neglected soft tissue foreign bodies, allowing for successful removal with minimal soft tissue exploration and dissection 5.
Considerations
- Most ear foreign bodies can be addressed on a nonurgent basis, but batteries and caustic materials warrant prompt removal 2.
- Referral to an otolaryngologist should be considered for difficult cases or after a failed attempt 2.
- A detailed history and an otoscopic examination must precede the procedure of ear syringing 3.
- The pressure generated by the water jet on the eardrum during ear syringing is well below the pressure required to burst a tympanic membrane, making the technique safe to use 3.
Instrumentation
- The equipment for ear syringing consists of a disposable sterile kit, including a 20 ml syringe, saline at body temperature, and a 14 or 16 gauge cannula without the needle 3.
- US-guided removal of foreign bodies can be performed using surgical forceps inserted through a small incision in the skin, directed under US guidance to reach the foreign body and remove it 4.
- The cross-needle-guided technique uses two 23-gauge needles to achieve proper localization and fixation of foreign bodies during surgery 5.