Emergency Department Management of Foreign Bodies of the External Ear Canal in Children

Objective: To evaluate the management of foreign bodies in the external auditory canal (EAC) in pediatric patients by emergency department personnel.

Setting: Tertiary care pediatric hospital emergency department.

Study Design: A retrospective chart review of children with foreign bodies of the EAC over a 12-month period. Age, foreign body type, rate of successful removal, and complication rates were recorded. Foreign bodies were categorized into two groups: objects with smooth surfaces and not easily grasped (nongraspable) and objects with irregularly shaped surfaces and easily grasped (graspable).

Results: Thirty-six patients were brought to the emergency department over a 12-month period with foreign bodies of the EAC. Their mean age was 6.5 years (range, 1-16 yr). Numerous foreign bodies were noted; beads were the most common. Successful removal was achieved in 53% of cases, and one or more complications were recorded in 47%. When the foreign bodies were grouped into nongraspable and graspable objects, the success rate for the nongraspable group was 45%, with a complication rate of 70%, whereas for graspable objects the successful removal rate was 64%, with a complication rate of only 14%. The difference in complication rates was statistically significant (p < 0.001.)

Conclusion: This study demonstrates that certain foreign bodies (graspable type) of the EAC in pediatric patients can be successfully managed by skilled emergency department personnel with low complication rates, whereas other foreign bodies (nongraspable types) may be better managed by early referral to an otolaryngologist.