Otoscopy :: THE EXTERNAL CANAL :: Fig7_13
 THE EXTERNAL CANAL  
Foreign Bodies In the External Canal
(Foam Rubber)

Foreign Bodies In the External Canal
(Foam Rubber)

Description : Definition
Any foreign material located within the external auditory canal.

Etiology
A wide selection of foreign bodies have been discovered in the external auditory canal. In children, small plastic beads, toy building materials, foam rubber and paper are currently in vogue, whilst in adults a forgotten piece of cotton wool is commonly encountered by the examiner.

Symptoms
Pain, irritation, hearing loss and otorrhoea can all occur. Relatively inert materials may produce no symptoms whatsoever and may only be discovered inadvertently during a routine otoscopic examination whereas vegetable material tends to cause a localized external otitis.

Occasionally, the fluttering or scratching movements of a living insect in the external canal will cause considerable distress.

Otoscopic appearances
The type of foreign body present can usually be recognized without difficulty unless wax or secondary infection with discharge obscures the picture.

Treatment guidelines
The aim is to remove the foreign body as safely and expeditiously as possible, while avoiding damage to the delicate skin of the external auditory canal, the tympanic membrane and the ossicles.

The method of choice depends on the type of foreign body present. Smooth, hard, round objects such as beads are best removed with a blunt wax hook while aural crocodile forceps are more suitable for those foreign bodies which present an edge and can be easily grasped, e.g. paper, foam rubber or cotton wool.

A small aural suction tube of the Bellucci pattern is invaluable in many cases.

If the foreign material is fragmented and not totally blocking the canal an aural syringe can be used to flush it out.

Insects are best floated out by filling the canal with water or oil. This is a simple measure which may prevent a camping holiday from being spoilt.

In uncooperative patients, and especially in children, it may be impossible to remove the foreign body safely and painlessly.

A short general anesthetic is then advisable to avoid the possibility of damaging the external canal and tympanic membrane.

A piece of blue sponge rubber is seen blocking the external auditory canal.

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