The aural foreign body space: A review of pediatric ear foreign bodies and a management paradigm

Abstract

PurposeWe aim to describe and review the management of pediatric aural foreign bodies (FBs). MethodsWe performed an observational study and retrospective chart review with statistical analysis of management for patients presenting with aural FBs to the Emergency Department (ED) with or without ENT consultation, or presenting directly to the ENT clinic. ResultsThere were 166 objects in the ears of 155 children. Paper and beads were the most common objects. Micro-alligator forceps and small right-angle hooks were the most commonly used instruments for removal. 60% of patients had attempted removal prior to referral to Otolaryngology, who removed 72% of the FBs in the outpatient setting, 23% in the operating room, and 2.5% in the ED. ConclusionTaking into account certain characteristics of the object reflects an efficient manner in which to determine referral of difficult removals to Otolaryngology. Providers should determine if the FB is very hard or very soft and spherical or cylindrical with secondary consideration of cost to the patient and hospital in order to properly navigate treatment. Soft and irregular objects may be extracted without need for referral to Otolaryngology. Patients with aural FBs that are hard or round, in instances which previous attempts have failed, and/or where there is trauma to the ear should be referred to Otolaryngology to avoid worsening the position of the FB and increasing the chances of requiring removal in the operating room.