
Overview
This module describes how to remove a foreign body from the external auditory canal.
Indications
Contraindications
Patient information and consent
Always verify your patient’s identity and obtain informed consent before proceeding.
How do I explain this procedure?
“There is something stuck in your ear canal and I need to remove it, because it can cause infection and damage to the tissues in your ear.”
What can my patient expect?
“Depending on what the object is, I will try to flush it out using water; however, some objects swell up in water, so I will insert an instrument behind it and hook it. This will be uncomfortable, but not painful.”
What is my patient’s role?
“Describe exactly what the object is, as this will help me know how to remove it. Please try to remain very still during this procedure.”
Preparation
Evaluate the patient’s external auditory canal and tympanic membrane, and enquire about the patient’s ear
health
Patients may insert objects into their ear in an attempt to relieve their symptoms.
(otorrhoea, otalgia or hearing loss), indicating possible perforated membrane or concurrent pathology and referral to ENT.
If the foreign body is a bug, kill it first by
instilling
If you know that the tympanic membrane is perforated, do not instil anything into the ear.
lignocaine, alcohol, or mineral oil into the ear canal. The patient may be distressed, anxious and unable to cooperate.

Documentation
Equipment
The type of equipment will vary depending on the
type of foreign body
Graspable foreign bodies are foam, rubber, paper and vegetable material. Non-graspable foreign bodies are beads, pebbles and popcorn kernels.
, the patient’s cooperation and where it is located.
Site & Positioning
Cooperative patients can either sit or lie down with the affected ear turned towards the provider.
For small children, let an assistant or parent hold the child. Wrap the child in a sheet and sit them upright, facing you on the parent’s lap with the child’s legs restrained by the parent’s crossed legs. The parent holds the child’s body with one arm, and the child’s forehead with the other. Rest the back of the child’s head against the parent’s body.
Procedure
Follow medical asepsis without gloves.
Troubleshooting
I do not have a right angle hook/curette/Jobson Horne probe.
If the foreign body is hard and spherical, do not attempt to grasp it with the forceps, risking pushing it further into the ear canal. If you are unable to syringe it out because of the risk of swelling of the object, refer the patient to ENT.
I am unable to grasp the object, or remove it by hooking or syringing.
The foreign body may be stuck, embedded in thick wax, or touching the tympanic membrane. Refer the patient to ENT.
Attempted removal is very painful.
The foreign body may be sharp, or the tympanic membrane or ear canal may be damaged. Refer the patient to ENT.
The foreign body is styrofoam or superglue.
Use acetone to dissolve the styrofoam or loosen cyanoacrylate (superglue). Note that this should not be done when the tympanic membrane is perforated. If unsure, rather refer to ENT.