Foreign Bodies in the Ear, Nose, and Throat

Foreign bodies in the ear, nose, and throat are common in young children and can also occur in other populations. Patients with foreign bodies in the ear (ie, external auditory canal) are usually asymptomatic but can present with otalgia, sensation of fullness, hypoacusis, pruritus, and otorrhea (usually bleeding). Removal in the office may be attempted in cooperative or appropriately restrained patients with irrigation or instrumentation, depending on the type of object and degree of impaction. Similarly, nasal foreign bodies can often be removed safely in the office with positive pressure techniques followed by instrumentation when the object is visible. A wide range of tools and methods have been described, yet evidence is lacking to recommend specific instruments or techniques. Referral is indicated for patients with external auditory canal or nasal foreign bodies that are more difficult or dangerous to remove, such as when the patient cannot be safely immobilized, the object is penetrating or a button battery, or removal attempts have failed. Foreign bodies of the throat pose significant and immediate risks to the airway and require urgent emergency management. All patients with airway foreign bodies should be referred to the emergency department for sedation, direct visualization of the object via flexible or rigid endoscope, and removal.