Diseases Of The External Auditory Canal - III

• Incidence: Most commonly in children and mentally retarded persons.

• Types:

1. Animate foreign bodies as flies, larvae (myasis), mosquitoes, or fleas.

2. In-animate foreign bodies:

• Vegetable foreign body as beans and peas, they swell with water.

• Non-vegetable foreign body as pieces of papers, beads or buttons, they do not swell with water.

• Clinical picture:

  1. May be asymptomatic.

  2. Hearing loss, when the foreign body occludes the external canal.

  3. Animate foreign body causes severe irritation, and noise in the ear.

4. The foreign body is easily detected on clinical examination .

• Treatment:

1. Instruments (such as hooks):

• Can remove all foreign bodies.

• Should be used to remove impacted or large vegetable foreign body.

• General anaesthesia is necessary in cases of impacted foreign body and uncooperative patients as children .

2. Ear wash:

• Can remove most foreign bodies.

• Contraindicated in case of impacted or large vegetable foreign body.

• Insects should be killed by alcohol or oil before wash.

3. General anesthesia and a post-auricular incision and widening of the bony canal may be needed in cases of impacted foreign bodies especially when other measures fail.

figure 22: Removal of a foreign body with a hook.

• Complications:

Produced by the foreign body enterance or during unskilled attempts of its removal:

1. Injury of the external canal, tympanic membrane, ossicles.

2. Otitis externa or otitis media.

Category: ENT Notes