Foreign Body in Ear: The Daily PANCE Blueprint
A 6-year-old boy presents to the clinic with pain in his left ear. On an otoscopic exam, you notice an insect in the auditory canal. What is the best way to manage this patient?
A. Irrigation with cool normal saline
B. Immediate suction removal
C. Insert a wick into the ear to trap the insect
D. Insert lidocaine solution to kill the insect then use forceps for removal
E. Irritate the insect with a cotton swab and hope it flies out
Answer and topic summary
The answer is D. Insert lidocaine solution to kill the insect, then use forceps for removal
An ear foreign body typically happens in children less than 8 years old; common objections include beads, marbles, cotton balls, earrings, and insects. Clinical features may include ear fullness, otorrhea, hearing loss, otalgia, or possibly no symptoms. Otoscopy is used to visualize the foreign body. Removal techniques include forceps, suction, or water irrigation. Water irrigation is contraindicated if the item in the ear expands with water. Insects should actually always be killed before removal is attempted by the provider. Any sharp foreign body or signs of damage to a part of the ear warrants a referral.
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