Ear foreign body in Adult
Often, the foreign bodies found in the pinna are embedded pierced earrings. Contact dermatitis, pressure from earring clips kept too tight, and poor hygiene can lead to skin ischemia, inflammation, and ulcer formation, leading to the earring becoming encapsulated within the skin. This condition is often seen in girls under 10 years old with a history of a recent ear piercing. These patients commonly present with ear pain, redness, swelling, and purulent drainage. The earring may be palpable, especially when located in the earlobe, but palpation will often be very painful. This condition can be complicated by chondritis and perichondritis, often characterized by infection with Staphylococcus aureus and Pseudomonas aeruginosa.
Objects located in the external auditory canal often are symptomatic as well. In children, a variety of small objects are often found, including toys, stones, beads, folded paper, and biologic materials such as insects or seeds. Children with conditions that irritate the ear (eg, cerumen impaction, otitis media or externa), attention deficit disorder with hyperactivity, or pica are predisposed to ear foreign bodies, as are adults with psychiatric conditions or intellectual disability. Foreign bodies are most often found in the canal corresponding to the predominant handedness. In adults, cotton swabs / first-aid products are commonly found objects, as well as hearing aid materials and insects.
T16.9XXA – Foreign body in ear, unspecified ear, initial encounter
75441006 – Foreign body in ear
Differential Diagnosis & Pitfalls
Other diagnostic considerations include:
- Congenital cholesteatoma – Abnormal accumulation of squamous epithelium within the mastoid and middle ear may appear similar to a round, white foreign object. Cholesteatomas are located within the middle ear and palpation with a probe allows differentiation.
- Cerumen impaction – Abnormal accumulation of earwax. Symptoms are similar. If not differentiated prior to removal from ear, will be differentiated post-removal.
- Hematoma – Will have history of trauma.
- Tumor – Palpation with a probe often allows differentiation. Will likely bleed.
- Tympanic membrane perforation – No obstruction of ear canal will be observed.
- Ear infection – No solid obstruction of ear canal will be observed.