Foreign Bodies in the Ear

[BJJVP]

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Anyone have any tricks for getting foreign bodies out of the ear? My last several shifts have been painful because of prolonged attempts to remove FBs from the ear from kids (one was a roach and the other was a bean).

My usual approach is to visualize the FB with the otoscope and then try removal using an overhead light and a curette, flushing with saline/angiocatheter, katz extractor, or forceps. The order depends on what I think will work best. Just trying to visualize the FB while attempting to remove it can be a challenge by itself.

What do the ENTs do differently or do they have special tools when they get these cases in the office? I asked one and he said he does what I've already tried again in the office.

 

[Poetic Silence]

Had one of those in my ear once. An FM doc squirted water up there and flooded it out. Baby roach.

 

[Poetic Silence]

Or maybe it was saline.

 

[cofcemt]

ENTs us an indirect scope that they can visualize the canal through a large ear speculum and use alligator forceps or curette through. Makes it so much easier to remove FBs from the canal.

 

[Daiphon]

Anyone have any tricks for getting foreign bodies out of the ear? My last several shifts have been painful because of prolonged attempts to remove FBs from the ear from kids (one was a roach and the other was a bean).

My usual approach is to visualize the FB with the otoscope and then try removal using an overhead light and a curette, flushing with saline/angiocatheter, katz extractor, or forceps. The order depends on what I think will work best. Just trying to visualize the FB while attempting to remove it can be a challenge by itself.

What do the ENTs do differently or do they have special tools when they get these cases in the office? I asked one and he said he does what I've already tried again in the office.

Dermabond or Mastisol on the end of a qtip... works best on dead things.

Sent from my DROID BIONIC using Tapatalk

 

[pratik7]

I recently had a bug in the ear and as soon as i put the otoscope light in the ear the dang thing came crawling out. The lady nearly lost her $hit

 

[Apollyon]

I recently had a bug in the ear and as soon as i put the otoscope light in the ear the dang thing came crawling out. The lady nearly lost her $hit

It is better than her losing her **** because of the logical entomologic response to light - to run away (and deeper into her ear, which would not be possible, but would be doing a dance on her TM).

 

[MRSAful Fate]

It is better than her losing her **** because of the logical entomologic response to light - to run away (and deeper into her ear, which would not be possible, but would be doing a dance on her TM).

A doc I was shadowing took advantage of the nocturnal nature of cockroaches and had a teenager lie still in the isolation room with the lights off. The roach came out on it's own after about 30 minutes. I can't see this working with every patient, but it was an easy fix that time. No one found the roach though, I hope the next patient in the isolation room didn't get a suprise...

 

[deleted109597]

Dermabond or Mastisol on the end of a qtip... works best on dead things.

Kill with auralgan. Best of all worlds.

Actually though, it works best on organic items. So the plastic and metal beads don't stick as well. Worth a try though.

 

[txterp98]

Have you ever used a Hognose otoscope speculum? It has a tube that connects to wall suction and then you occlude the otoscope insufflation port as a means of establishing a vacuum. Pretty slick tool if you have one available.

 

[Aesculapius]

Mineral oil kills bugs; ditto isopropyl alcohol and ethanol. Lidocaine apparently makes them run away, too...

 

[leorl]

have had some success with regular lido. Caution not to use viscous lido or use sparingly. It suffocates the roaches but then makes them so soft that they break in many pieces when you're trying to dig them out after.

 

[med2UCC]

have had some success with regular lido. Caution not to use viscous lido or use sparingly. It suffocates the roaches but then makes them so soft that they break in many pieces when you're trying to dig them out after.

Ick!

I generally flush them out with water. Seems to work for most things but thank God, no roaches here.

 

[pinipig523]

Had a patient with an ear wig bug 2 weeks ago.... still alive. I squirted approx 4cc of lidocaine in there, let her sit unaffected ear down for about 10 seconds, then I had her sit with affected ear down...

The bug ran out and basically collapsed on the floor.

 

[JCTWP46]

I work as a scribe in the ED. I once assisted a physician in removing a roach from a pt's ear through using alcaine to numb the roach so it would let go of the pt's canal before removing with alligator forceps.

 

[alehar]

Angiocath and NS can work wonders as a conservative approach.

I've also heard anecdotal evidence about turning off the lights and letting it leave on its own (assuming it's a roach).