Foreign Body in the Ear

What to do right now

1. Stay calm and stop poking. Do not use cotton swabs, tweezers, hairpins or fingers in the canal. These push objects deeper and can scratch the canal or puncture the eardrum.
2. Tilt the head so the affected ear faces down, and gently shake the head. Do not hit the head.
3. If you can clearly see a soft object at the very opening, you can try to lift it out with blunt tweezers. Stop if it moves inward.
4. For a live insect: turn the ear upward and drip in a few drops of mineral oil, baby oil or olive oil at body temperature. This kills the insect and it may float out. Do not do this if there is bleeding, discharge, pain suggesting a perforated eardrum, or ear tubes.
5. For a button battery: do not put in oil or water. Go to the ER at once.
6. For food, seeds or beans: do not add water or oil, which makes them swell. Seek care.

If any of these fail, get medical help. Most ear foreign bodies can wait a few hours for a clinician, except batteries.

Common objects and what they mean

Symptoms

Many children have no symptoms and the object is found by chance. Others have:

• Ear pain or a feeling of fullness
• Muffled hearing in that ear
• Buzzing or movement sounds with an insect
• Discharge, a bad smell or bleeding from the ear, especially if the object has been there for days
• A young child pulling at the ear or crying

How doctors remove a foreign body in the ear

The clinician looks into the ear with an otoscope or microscope to identify the object and check the eardrum. The ear canal is very sensitive and the inner part has thin skin over bone, so a still head is essential. Young children may be wrapped or held by a parent, and some need sedation.

Methods depend on the object:

• Suction with a fine catheter for small, smooth items
• Small forceps (alligator forceps) for soft or irregular objects with an edge to grip
• Right-angle hooks or loops passed behind round objects such as beads to roll them out
• Irrigation with body-temperature water for small inert objects. It is not used for batteries, vegetable matter, or when the eardrum may be perforated
• Cyanoacrylate glue on a stick in some clinics for smooth round objects

After removal, the canal and eardrum are checked again. Antibiotic ear drops may be given if the canal is scratched or infected. If the first attempts fail, the patient is referred to an ENT specialist rather than making repeated tries, because each failed attempt makes swelling and bleeding worse. Some children need removal under general anesthesia.

Complications

• Cuts and bleeding of the ear canal (ear canal injury)
• A torn eardrum (eardrum perforation), which usually heals by itself over weeks
• Outer ear infection (otitis externa) from an object left in place
• Burns, narrowing of the canal, or damage to the middle ear from button batteries
• Temporary conductive hearing loss

Prevention

• Keep button batteries, magnets and small toy parts out of reach. Make sure battery compartments on toys and remotes are screwed shut.
• Do not use cotton swabs inside the ear canal. Earwax normally clears by itself.
• Use earplugs that fit properly and remove them by the tab.
• If a child often puts objects in their ears or nose, ask the clinician to check the other ear and both nostrils as well, since a second object is sometimes found.

Frequently asked questions

How do I get something out of my ear at home?

Tilt the affected ear down and gently shake the head. If a soft object is clearly visible at the opening, lift it out with blunt tweezers. For a live insect, drip in warm mineral or olive oil. Stop and see a clinician if it does not come out easily, if there is pain or bleeding, or if it is a battery.

Is a foreign body in the ear an emergency?

Usually not. Most objects can safely wait a few hours for removal by a doctor. Exceptions are button batteries, which can burn the ear within hours, and objects causing severe pain, heavy bleeding, dizziness or sudden hearing loss. These need the ER right away.

How do you get a bug out of your ear?

Do not poke at it. Lie with the ear facing up, pull the outer ear gently up and back to straighten the canal, and drip in a few drops of mineral, baby or olive oil to stop the insect moving. It may float out. If it does not, or if pain continues, a clinician can remove it with suction or forceps.

Can an object stay in your ear without you knowing?

Yes, especially a cotton swab tip or a small bead in a child. Weeks later it may cause pain, smelly discharge, itching or muffled hearing. An infection that keeps returning in one ear, especially in a child, should prompt a careful look for a hidden object.

Can a foreign body in the ear cause hearing loss?

It can cause muffled hearing while it blocks the canal, which recovers once it is removed. Lasting hearing loss is uncommon and usually comes from a perforated eardrum, middle ear damage from rough removal attempts, or a button battery burn.