Foreign Body (Object) in the Ear

Picture of the anatomy of the ear

• Getting an object stuck in the ear is a relatively common problem, especially in toddlers. The vast majority of items are lodged in the ear canal, which is the small channel that ends at the eardrum. Because the ear canal is quite sensitive, you can usually tell if there is something in your ear.
• Most cases of foreign bodies in the ear are not serious and can usually wait until the morning or the following day for removal. The object does, however, have to be completely removed quickly and with the least amount of discomfort and danger.
• Common objects found in ears include food material, beads, toys, and insects. Children often place items in their ears out of curiosity.
• Although earwax (cerumen) is not technically a foreign body, it does frequently accumulate in the ear canal and can cause discomfort or decreased hearing just like other foreign bodies.

• The vast majority of objects found in ears are placed there voluntarily, usually by children, for an endless variety of reasons. A caregiver should not threaten a child when asking about this possibility, because the child may deny having put something in the ear in order to avoid punishment. This denial could easily result in a delay of its discovery and increase the risk of complications.
• Insects are well known to crawl into the ear, usually when you are asleep. Sleeping on the floor or outdoors would increase the chance of this unpleasant experience.

Fortunately, most people can tell if there is something in their ear. The ear canal, where most objects get stuck, is very sensitive. The ear canal ends at the eardrum, which is also highly sensitive. The symptoms of having a foreign body in the ear largely depend on the size, shape, and substance involved.

• Occasionally, a foreign body in the ear will go undetected and can cause an infection in the ear. In this situation, you may notice ongoing infectious drainage from the ear.
• Pain is the most common symptom. If the object is blocking most of the ear canal, you may experience a decrease in hearing on that side.
• Additionally, irritation to the ear canal can also make you nauseated, which could cause you to vomit. Some people may also cough or clear their throat because of stimulation of a nerve in the ear canal that also has a branch in the throat.
• Bleeding is also common, especially if the object is sharp or if you try to remove it by sticking something else into your ear.
• One of the most distressing experiences with this problem is having a live insect in the ear. The insect's movement can cause a buzzing in the ear and may be quite uncomfortable. Fortunately, dripping mineral oil into the affected ear will usually kill the insect. This is safe as long as you do not have a hole in your eardrum.

Most objects that become lodged in the ear should prompt a call to a doctor. If this object is causing no symptoms and the doctor's office is closed, an evaluation can usually wait until the following morning.

Depending on your particular medical community, your doctor may wish to see you in the office or refer you to a local emergency department or other specialists. Do not expect any health care professional to be able to assess the situation adequately over the phone. If there is any concern for the presence of a foreign body in the ear, you should be physically examined by a qualified medical professional.

• Persistent pain, bleeding, or discharge from the ear could mean that the ear passages have not been completely cleared, part of the object could remain inside the ear, or an infection of the ear canal has developed. These infections generally respond well to antibiotic drops, but an exam and prescription are necessary.
• A foreign body in the ear can also damage the eardrum, which may or may not affect hearing. Because you can’t see the eardrum from the outside, an exam of the ear is recommended.

In the majority of cases, the situation of having something in your ear will not be life-threatening. Usually, you will have time to call your regular doctor. The urgency of the situation primarily depends on the location of the object and the substance involved.

• Button batteries commonly found in many small devices and toys can decompose enough in the body to allow the chemicals to leak out and cause a burn. Urgent removal is advised.
• Urgent removal is also recommended for food or plant material (such as beans) because these will swell when moistened.
• An urgent examination is indicated if the object is causing significant pain or discomfort, or there is significant hearing decline or dizziness.

Most objects can be seen with good lighting and a few instruments.

• Occasionally, an object is discovered accidentally when X-rays are taken for unrelated reasons. It is important to realize that many materials such as food, wood, and plastic will not be visible on a routine X-ray.
• Do not hesitate to ask your doctor to examine the entire head and neck region. It is distinctly possible that the person has multiple foreign bodies in both ears and foreign objects in the nose.

It is often said that you should never put anything in your ear that is smaller than your elbow. The main reason to avoid blindly putting something into your ear is that it usually results in pushing any object deeper into the ear canal. This not only can damage the eardrum, but also make ultimate removal of the object more difficult. This is particularly true of earwax.

• Earwax is usually the consistency of toothpaste. When a Q-Tip or similar object is used to get the wax out, most of the wax is packed deeply into the ear canal. It then often hardens and is much more difficult to remove.
• The shape of the ear canal is slightly changed by pulling back on the ear's pinna (the circular part of the ear on the side of the head). By placing the affected ear down and gently wiggling the ear pinna, you may be able to shift the object enough to cause it to fall out.
• If an object becomes lodged in the ear and this technique fails, it is usually best to have it removed by a doctor who can view the object with proper lighting and instruments.
• Having a live insect in your ear can be extremely uncomfortable. People are often desperate to get the bug to stop moving. If you do not have a known hole in your eardrum, it is usually safe to place a few drops of mineral oil into the ear. This will kill the bug and allow you to calmly and safely get to a medical office for further care.
• If you have something in your ear (or your child does), and it appears that a doctor's visit will be necessary, avoid eating or drinking anything for 8 hours before the evaluation, if possible. Some objects require sedation for safe removal. Sedation is much safer if you have not swallowed anything for 8-12 hours before the procedure.

Treatment will largely depend on the location and object or objects involved. Do not be surprised if your doctor uses his or her own unique technique to remove an object. Years of experience often provide innovative techniques that are safe and effective.

• Commonly used techniques include applying a gentle suction to the object, small forceps, or instruments that have a loop or hook at the tip.
• If the object is metallic, a long instrument may be magnetized to assist in gently pulling the object from the ear.
• Another common technique involves irrigating the ear. If the eardrum appears intact, warm water can be gently squirted past the object using a small catheter. The water will turn around at the end of the ear canal and often wash the object out.
• Any experienced professional can tell you that children typically struggle with these techniques. Struggling will decrease the likelihood of success and increase the chance for complications. Sedation of the child may be considered an option to allow calm and comfortable removal of the object, if necessary.

A repeat exam after removal of an object in the ear is recommended. If the person has no symptoms, this exam can usually be done in a regular clinic within 1 week. If there is any continuing drainage, bleeding, or discomfort, a thorough exam by a qualified medical professional is imperative. With calm and careful treatment, this condition should be the source of entertaining memories and not serious health problems.

Most people recover completely after having a foreign object removed from the ear. If the skin of the ear canal has been injured, antibiotic drops are frequently prescribed to prevent infection. Although most infections are minor, the severity and extent may affect the outcome. Foreign objects can damage the eardrum and deeper structures of the ear. This damage can affect hearing. Such injuries are often best treated by an otolaryngologist (ear, nose, and throat specialist).

Curiosity and exploration of one's body is a natural stage of development. Teaching a child that it is not good to put anything into the ear may prevent some of these mishaps. If you suspect a child has put something in his or her ear, it is important to approach these situations in a nonjudgmental manner, so that the objects can be discovered and safely removed before complications develop.