Live foreign bodies in EAC/ME

[AngkorWuT]

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Bedside? OR? Saw an interesting case and would like to know what YOU would do...

Personally, I'd do it under anesthesia (patient may be combative at bedside) and just remove the nasty suckers under operative microscopy. Would you kill it first or just take it out?

Oh...also a t-bone fx with possible CSF otorrhea (could just be ME fluid).

 

[resxn]

Rarely need to go to the OR. Paralyze/kill with lidocaine into the EAC for a couple of minutes. Obviously depends on the cooperativity of the pt, but I've taken live things out on kids as young as 14 months without a problem.

 

[AngkorWuT]

What about in the setting of a perfed TM and possible CSF otorrhea?

 

[resxn]

What about in the setting of a perfed TM and possible CSF otorrhea?

You could pull the live critter in the clinic, without lidocaine, but a TM perf with CSF leak is a surgical indication anyway, so I'd just go to the OR ASAP. That could end up being all sorts of things from a tegmen defect to something in the mastoid to PLF or whatever.

I'd let my esteemed neurotologist colleague chime in more on that one because if I suspected that, I'd be sending the pt to them anyway.

 

[neutropeniaboy]

What about in the setting of a perfed TM and possible CSF otorrhea?

Tbone fracture, perf, otorrhea and a bug in the ear? 😱 Talk about bad luck. Or is the otorrhea a different scenario?

Need more info on this case...

 

[gstrub]

I leave you to guess what I am looking at on this ear exam

 

[Apollyon]

I leave you to guess what I am looking at on this ear exam

I'm not seeing the image. I tried to paste it into another browser window, and I got a "stale handle" message.

 

[gstrub]

I can't seem to get it to post the pic...working on it

 

[Heatwave]

I leave you to guess what I am looking at on this ear exam

That's the joke. There is no picture so you have to guess 😀