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Foreign Body, Ear, Emergency Medicine

Kathleen Nasci and Charles V. Pollack, Jr. Reviewed 06/2017
 


Basics

Description

  • Foreign bodies (FBs) lodged in the external auditory canal

  • The external auditory canal:

    • Cartilaginous and bony passage lined with periosteum and skin

    • The periosteum is extremely sensiti...

Diagnosis

Signs and Symptoms

  • Decreased hearing

  • Excessive crying in infants

  • Unilateral ear pain

  • Fullness

  • Loud noises

  • Buzzing sound (with live insects)

  • Nausea

  • Dizziness

  • Ipsilateral tearing

  • Purulent discharge from...

Treatment

Pre-Hospital

  • Cautions:

    • Severe ear pain, sensation of movement, and loud, buzzing sound:

      • Typical signs of a live insect in external auditory canal

      • Instill warm lidocaine or mineral oil into affec...

Follow-Up

Disposition

Admission Criteria

Hospital admission if the FB is a button battery that cannot be removed 

Discharge Criteria

  • FB removed

  • Inability to remove a FB that will not cause rapid tissue nec...

Pearls and Pitfalls

  • Use procedural sedation with uncooperative patients or when a difficult removal is anticipated

  • Irrigation in patients with button batteries in the ear should never be performed as t...

Additional Reading

  • Brown  L, Denmark  TK, Wittlake  WA, et al. Procedural sedation use in the ED: Management of pediatric ear and nose foreign bodies. Am J Emerg Med.  2004;22:310–314.

  • Cederberg  ...

Codes

ICD9

931 Foreign body in ear 

ICD10

  • T16.1XXA Foreign body in right ear, initial encounter

  • T16.2XXA Foreign body in left ear, initial encounter

  • T16.9XXA Foreign body in ear, unspecified ear, initial e...

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