Ant in Ear Canal

Dec 25, 2024

A 7-year-old male presented to the pediatrician's office with fever, vomiting, and diarrhea. The child was diagnosed with viral gastroenteritis. As part of the complete physical exam, the following image was obtained of his left ear with the WiscMed Wispr digital otoscope. When asked about the finding of the ant in the ear, the mother mentioned that they occasionally see ants in the house. Ten days ago, the child woke up with severe left ear pain. The mother gave ibuprofen and instilled otic ear drops. The pain was gone almost immediately.

What is the next step in management?

A. Refer the child to otolaryngology (ENT) for removal
B. Remove the ant with a forceps
C. Remove the ant with lavage
D. Remove the ant with a Q-Tip

Answer: C. Remove the ant with lavage

A reasonable first attempt would be to remove the ant with lavage – i.e. rinse the dead ant out of the external ear canal. However, in this case, the ant was adherent to the canal wall, and the lavage was unsuccessful. Using a forceps will not work as it would likely break the dead ant into many pieces. A Q-Tip would have the same issue as a forceps. In this case, the child was referred to ENT for complete removal of the ant.
Foreign bodies in ear canals are very common. Examples include beads, tic-tacs, pencils, ticks and hearing aid tips.

Key Learning Points:

Foreign bodies in the external ear canal are common.
Removal of the foreign body is facilitated by proper visualization.
Removal technique depends on the nature of the foreign body.
With a pediatric patient, you generally get one chance at removal before an ENT consult and sedation is required.

WiscMed thanks Dr. Joao Mauricio Scarpellini Campos for this interesting case. Dr. Campos is a pediatrician in private practice in Rio de Janeiro, Brazil.

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