Bugs or foreign body in ears or nose is a common scenario encountered by parents. Children or infants have a tendency to insert small objects like buttons, beads, stone, paper, etc.. into their mouth, nose or ears. Objects inserted into the mouth are usually swallowed and may go unnoticed. Foreign body inserted into the nose or ears tend to create block resulting in infections. Similarly small insects like cockroaches and bugs are known to enter into the ears.
MOST COMMON OBJECTS :
Beads
Eraser
Paper
Piece of toys or crayon
Batteries
Food (Pulses)
Stones
Insects
Among the objects inserted, most of them are harmless but some of these objects can be really harmful. A battery stuck in the nose can be really dangerous as it causes severe chemical reaction resulting in bleeding, infection and complications like eroded cartilage. Insects or bugs in ear can also be a problem maker, the highly sensitive ear canal can trigger severe pain with the movement or trauma created by the insect while moving within in the canal. Insects can also result in injury to the tympanic membrane or ear drum.
WHAT CAN BE DONE AT HOME?
Parents should first check if they are able to visualize the foreign body in the nose or ears.
Once visualized, the first attempt should be to use the power of gravity to extract the foreign body. Try tilting or gently shaking the head to remove the foreign body. Do not bang or strike on the opposite side, to dislodge the foreign body as it will only result undesired effect.
At attempt to remove it should only be made if you are confident that it can be removed in a single attempt, without pushing it deeper or causing any trauma. Usually a tweezer is the best instrument available at home for removal of a foreign body.
Insects in the ear can be tricky business to handle at home. Apply few drops of warm baby oil into the ear. This will ensure that the insect does not move and may help in floating the insect out of the ear with a tilt.
Pulling the ear (PINNA) upward and backward will help you straighten the ear canal thus making it easier for the foreign body to role out.
*The oil should only be warm and not hot. Warm oil should not be used if there is ventilation tube or perforation in the ear drum.
Always remember, there is no harm in doing nothing if doing something is more harmful. In such situations its best to visit the emergency department of any hospital or your family physician at the earliest.
There has been multiple studies done to check if the expertise of an ENT specialist is essential in removing foreign bodies from ear or nose. In a study by T. Mackle et al, 65% of foreign body from nose and only 7% of foreign body ear was successfully removed at emergency department. This clearly shows the need of an expertise to remove the foreign body in ear.
In my experience, application of warm baby oil kills the insect but does not always ensure the removal of the foreign body from the ear. Hence its always advisable to consult your family physician in such events to ensure the foreign body has been completely removed and to check the extend of any trauma that has been created.
Always remember the child will be terrified or scared about the foreign body in his/her ear or nose. Any form of scolding or punishment by the parents with regard to this matter, will make the situation worse as child will be uncooperative by the time you reach the hospital. I always try to take the child into confidence by demonstrating the method used for foreign body removal on his/her hand. The doctors job is half done if the child cooperates for the procedure.
In case of ear, a suction machine or crocodile forceps is my first choice in removal of the foreign body. In some rare cases, I have syringed using warm water or saline to push out the foreign body. In the case of foreign body nose, an endoscopy guided removal using an eustachian tube catheter / forceps or a hook is the best method in my experience. A direct attempt without an endoscope can be made if the foreign body is easily visible.
Reference
1. International Journal of Pediatric Otorhinolaryngology
Volume 70, Issue 3, March 2006, Pages 425-428
2. International Journal of Pediatric Otorhinolaryngology
Volume 71, Issue 2, February 2007, Pages 191-195
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