Foreign Body

A healthy 18 year-old-female presents to the allergy clinic for evaluation. She has no history of ear problems, nor does she have any ear complaints. As part of the complete physical examination, the following image of the patient’s left ear is obtained with the Wispr digital otoscope.

What is the next step in management?

The patient has an incidental finding of a foreign body in the external ear canal. This should be removed. It’s surprisingly common for people to have foreign bodies in their ear canals and not be aware. Here is another case that demonstrates a similar scenario. The image clearly shows the foreign body lodged some distance away from the tympanic membrane (TM, ear drum). In addition, the TM appears healthy with no erythema or perforation. The malleus is clearly visible. In a cooperative adult, there are several choices for foreign body removal. Techniques could include forceps, lavage, or Katz extractor. In this case, the foreign body was uneventfully removed with lavage. Here is a photo of the foreign body after removal. The patient recognized the item as part of an earbud.

WiscMed thanks James Thompson, MD of Chisholm Trail Allergy and Asthma in Fort Worth, TX for this week’s interesting case.