Ear foreign body: Difference between revisions
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==Management== | ==Management== | ||
*Button battery | |||
**Removal ASAP in consultation with ENT | |||
*Insect | |||
**Kill with mineral oil, EtOH, or 2% lidocaine prior to removal | |||
*Penetrating FB's | |||
**Low threshold for ENT consult | |||
**[[Tympanic membrane rupture]] | |||
===Removal=== | |||
*Irrigation | |||
**Contraindicated if suspected TM perforation, tympanostomy tubes, button battery, or vegetable parts (swells) | |||
**Body temperature sterile water or normal saline | |||
**Attach 14 or 16 ga IV catheter to syringe | |||
*Alligator forceps | |||
*Right angle tool / day hook | |||
*Schuknect extractor (attaches to wall suction) | |||
*Dermabond on a swab stick | |||
**Allow glue to become tacky before inserting into canal | |||
==Disposition== | ==Disposition== | ||
Revision as of 19:52, 26 May 2015
Background
- Usually children 6 yo or younger
Clinical Features
- Caregiver often reports seeing child put something in the ear
- Decreased hearing or otalgia
- More common on right (hand dominant) side
- May have otorrhea or bleeding
Differential Diagnosis
Ear Diagnoses
External
- Auricular hematoma
- Auricular perichondritis
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
Internal
- Acute otitis media
- Chronic otitis media
- Mastoiditis
Inner/vestibular
Diagnosis
- Typically seen on visual inspection or otoscopy
- Check other ear / nares
Management
- Button battery
- Removal ASAP in consultation with ENT
- Insect
- Kill with mineral oil, EtOH, or 2% lidocaine prior to removal
- Penetrating FB's
- Low threshold for ENT consult
- Tympanic membrane rupture
Removal
- Irrigation
- Contraindicated if suspected TM perforation, tympanostomy tubes, button battery, or vegetable parts (swells)
- Body temperature sterile water or normal saline
- Attach 14 or 16 ga IV catheter to syringe
- Alligator forceps
- Right angle tool / day hook
- Schuknect extractor (attaches to wall suction)
- Dermabond on a swab stick
- Allow glue to become tacky before inserting into canal