While we may not plan to leave an EAC FB in place for over 2 months, like this study did, a shorter duration less than 1 week may not be unreasonable. The literature suggests we can remove the EAC FB a majority of the time although certain FB characteristics—like whether it is able to be grasped and its location in respect to the TM—should factor into our decision-making.

Summary

EAC foreign body retrieval in the ED setting is successful a majority of the time with success rates most commonly in the range of 53–86 percent. Hard, smooth-surfaced objects, such as beads, rocks, and seeds tend to have the lowest success rates. Removal of non-button battery EAC FBs is not typically emergent and can likely be done with a reasonable outpatient clinic referral if you cannot easily extract it yourself.

Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York.

References

1. Karimnegad K, Nelson, EJ, Rohde RL et al. External auditory canal foreign body extraction outcomes. Ann Oto Rhinol Laryngol. 2017;126(11):755-761.
2. Mingo K, Eleff D, Anne S et al. Pediatric ear foreign body retrieval: a comparison across specialties. Am J Otolaryngol. 2020;41(2):102167.
3. Duan M, Morvil G, Badron J, et al. Epidemiological trends and outcomes of children with aural foreign bodies in Singapore. Ann Acad Med Singap. 2022;51(6):351-356.
4. Ngo A, Ng KC, Sim TP. Otorhinolaryngeal foreign bodies in children presenting to the emergency department. Singapore Med J. 2005; 46(4):172-8.
5. DiMuzio J, Deschler DG. Emergency department management of foreign bodies of the external ear canal in children. Otol Neurotol. 2002; 23(4):473-5.
6. Ho GC, Thind R, Yap D, et al. A change in clinical practice for aural foreign bodies—what we learnt from the coronavirus disease 2019 pandemic. J Laryngol Otol. 2021;135(9):825-828. .
7. Shih M, Brock L, Liu YC. Pediatric aural foreign body extraction: comparison of efficacies among clinical settings and retrieval methods. Otolaryngol Head Neck Surg. 2021;164(3):662-666.