Overview
Introduction: Mostly Minor, Occasionally Catastrophic
Ear trauma and aural foreign bodies span an unusually wide clinical range.
Ear trauma and aural foreign bodies span an unusually wide clinical range. Most are genuinely minor — a bead in a toddler's canal, a small traumatic perforation that heals itself. A few are emergencies where delay causes permanent harm, and one — the button battery — can destroy tissue within hours. Three principles organize the whole topic, and each one is about restraint. First: never instrument blindly. The commonest serious harm in aural foreign body management is iatrogenic — inflicted by well-meaning attempts at removal. Repeated blind grabbing with forceps pushes objects deeper, lacerates the canal, perforates the tympanic membrane and turns a simple outpatient removal into a theatre case under general anaesthetic. One skilled attempt under direct vision beats three hopeful ones. Second: irrigation is not universally safe. It is a reasonable technique for some objects, and it is contraindicated for others — suspected perforation, tympanostomy tubes, button batteries, and organic material that swells. Reaching for a syringe without asking what the object is and whether the drum is intact is a recognized route to injury. Third: the ear...