Foreign bodies in the ear

Last updated: August 11, 2023

CME information and disclosurestoggle arrow icon

To see contributor disclosures related to this article, hover over this reference: [1]

Physicians may earn CME/MOC credit by searching for an answer to a clinical question on our platform, reading content in this article that addresses that question, and completing an evaluation in which they report the question and the impact of what has been learned on clinical practice.

AMBOSS designates this Internet point-of-care activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

For answers to questions about AMBOSS CME, including how to redeem CME/MOC credit, see “Tips and Links” at the bottom of this article.

Summarytoggle arrow icon

Foreign bodies in the ear are generally found in the external auditory canal and most often occur in children younger than 8 years of age. Toys (e.g., beads, marbles) are the predominant type of foreign body found in children, while cotton balls, jewelry, and insects are more common in adolescents and adults. Patients with a foreign body in the ear are often asymptomatic but may report symptoms such as a feeling of fullness in the ear, hearing loss, pruritus, otalgia, or discharge. Foreign bodies are diagnosed via otoscopy. Advanced imaging (CT/MRI) may be obtained if bony erosion, ossicular lesions, or other complications are suspected. Management consists of removal of the foreign body, with local anesthesia or procedural sedation as needed. In certain scenarios (e.g., tympanic membrane rupture, unsuccessful removal), specialist involvement may be required.

Epidemiologytoggle arrow icon

  • Most often occurs in children < 8 years of age [2]

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

  • Children: mostly toys (e.g., beads, marbles), food [2][3]
  • Adolescents and adults: cotton balls (e.g., from cotton swabs), jewelry (e.g., earrings), insects [2][3]

Clinical featurestoggle arrow icon

Patients are often asymptomatic, but they may present with nonspecific complaints (particularly children). [2][4]

A caregiver's report of an inserted object or nonspecific signs and symptoms may be the only features of ear foreign bodies in nonverbal or very young patients.

Diagnosticstoggle arrow icon

Especially in children, consider inspecting the other ear canal and both nostrils for additional foreign bodies. [2]

Managementtoggle arrow icon

Foreign body removal [2][4]

Instrument-assisted manual removal and/or irrigation are typically attempted in the emergency department or other outpatient settings.


Removal techniques [5]

The appropriate removal technique for each patient will vary based on the type of foreign body and the patient's ability to tolerate the procedure.

  • Instrument-assisted manual removal
    • Forceps
    • Blunt right-angle hook or ear curette
    • Balloon-tipped catheter (≤ 18 gauge)
    • Cyanoacrylate-tipped applicator [4][5]
    • Suction device
  • Irrigation
    • A 20-mL syringe and 14 to 16-gauge catheter are used to irrigate the ear with water or saline. [4]
    • Contraindications

Removal may cause patient discomfort and/or minor bleeding.

Special considerations

Disposition [2][4]

Consult ENT for the following:

  • Sedation required for removal
  • Trauma to the external auditory canal or tympanic membrane
  • Foreign bodies likely to cause tissue damage, e.g., sharp-edged objects, button batteries
  • Unsuccessful removal attempts

Complicationstoggle arrow icon

We list the most important complications. The selection is not exhaustive.

Referencestoggle arrow icon

  1. $Contributor Disclosures - Foreign bodies in the ear. None of the individuals in control of the content for this article reported relevant financial relationships with ineligible companies. For details, please review our full conflict of interest (COI) policy.
  2. Heim SW, Maughan KL. Foreign bodies in the ear, nose, and throat. Am Fam Physician. 2007; 76 (8): p.1185-9.
  3. Kim K-H, Chung JH, Byun H, Zheng T, Jeong J-H, Lee SH. Clinical Characteristics of External Auditory Canal Foreign Bodies in Children and Adolescents. Ear, Nose & Throat Journal. 2019; 99 (10): p.648-653.doi: 10.1177/0145561319893164 . | Open in Read by QxMD
  4. Walls R, Hockberger R, Gausche-Hill M, Erickson TB, Wilcox SR. Rosen's Emergency Medicine 10th edition- Concepts and Clinical Practice E-Book. Elsevier Health Sciences ; 2022
  5. Roberts JR. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. Elsevier ; 2018

Icon of a lock3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer