Foreign Bodies in the Ear, Nose, and Throat
Jane Emanuel, M.D.
Boys Town Ear, Nose & Throat Institute
As soon as somebody can pick up a little thing, that's the age where you see it. I probably see it more in the two to four year-old.
Foreign bodies in the ear, the foreign body isn't really going to go anywhere unless somebody start pushing it in farther. It' relatively dry so a little toy or a bead sitting there is not an emergency.
In a nose, that's a little bit more of a problem because if you have it in the nose, one if it sits there a long time, it starts to cause some inflammation or infection. If you try to get it out or someone does a big sniff it can actually go down into your trachea and cause a significant problem. So, nasal foreign bodies, I usually advise parents to have the child looked at fairly soon.
The third place would be the windpipe or esophagus. That's a reason to be seen right off the bat.
What objects are most commonly found?
Basically anything that's small enough to put in an ear or a nose. Toys, beads, beans, seeds, paper, foam, those are the things I mostly see in ears and noses.
I've found bugs in ears primarily. Those are some of the grosser and weird to think about items but once in awhile a bug does crawl into someone's ear. Basically if things are dark and you turn on a light, a bug can run in an ear or fly in an ear.
One important thing from a nose standpoint. Nasal foreign bodies, things especially like paper or foam, may get put up there and you won't know. If a child has one-sided, foul smelling nasal drainage, you probably have something up their nose.
From a swallowing standpoint, probably the biggest thing we end up seeing because it gets lodged is coins. Those need to be seen right off the bat.
What's the worst thing a child could get stuck?
The most dangerous thing is a battery and the little disc batteries are around in so many things now, hearing aids, toys and that kind of thing.
If you put a battery in your ear or your nose or get it lodged in your throat, that's an emergency. That needs to be taken care of. Any time you put moisture with that it's going to leak out some chemicals and it's going to cause a very nasty burn.
Can objects be removed in the clinic?
Most of the ear foreign bodies we do treat in the office. It varies on what the foreign body is, how cooperative the child is, how much we can hold them tight and do it.
Some of the kids we do see them after they've possibly been to the E.R. and they've had some attempts to take it out. We have a little better tools and specific foreign body things that make it a lot easier but if a child's been too traumatized and you can't get it out safely in the office, or if it's too far in the ear canal, there's a chance we may have to go to the operating room to take it out.
Nasal foreign bodies are a little bit of the same way. If it's something at the front of the nose that I feel I can safely take out without it going in the wrong way, we'll do those in the office as well.
If it's in the airway, of course, they're going to the operating room.
Should parents try to remove the object themselves?
Unless you can see it very, very well, you know what it is, and there is a piece of it hanging part way out of the nose, go ahead and try it.
In an older child if you want to have them try to blow their nose, that's certainly fine. If it's a piece of melt able candy, it's probably going to melt. So, I think there are a few situations where I think it's ok to wait, but in general, trying to take it out when you don't have the right tools, you might be causing more troubles.