Pemicu 3 Blok Penginderaan
Benda Asing
• PATHOLOGY
• The foreign bodies found most
commonly in the ear are, in order,
cotton wool, insects, beads, paper,
small toys and erasers.
• An eclectic mix of more unusual
foreign bodies has been described
in the literature.
• Seventy-two percent of
otolaryngology referrals from
failed attempts by nonspecialists
consist of firm, rounded objects
such as beads or beans
• CLINICAL PICTURE
• Foreign bodies in the external auditory
meatus are most commonly seen in
children who have inserted them into
their own ears.
• Children may present
asymptomatically, or with pain or a
discharge caused by otitis externa.
• Adults are often seen with cotton wool
or broken matchsticks which have been
used to clean or scratch the ear canal.
• Live insects in the ear, commonly small
cockroaches, are annoying due to
discomfort created by loud noise and
movement.
• MANAGEMENT OPTIONS • The nature of the foreign body
• Removal can vary from being simple to Techniques of removal advised for
being very challenging and frustrating.
different types of foreign body are
• Emergency or primary care physicians are
successful at removing about two-thirds of summarized in Living insects
foreign bodies under direct vision. In 82 should first be killed by instilling
percent of cases, these are irregularly oil into the meatus to drown them
shaped objects with soft, graspable parts. before removal.
• As a result, ear, nose and throat (ENT)
departments see the problem cases these
• Irregular/soft graspable non-living
practitioners could not solve. objects (dead insects, cotton wool,
• Prior to embarking upon removal, it may paper, small toys) may be removed
be useful to consider three aspects of the with a pair of crocodile forceps.
situation:
• Organic objects (beans, etc.),
1. the nature of the foreign body;
2. the precise location of the foreign body;
which may absorb water, swell and
3. the patient. cause pain, should not be syringed.
• Patient considerations Younger,
uncooperative children require special
handling.
• Prior unsuccessful attempts at removal
may have caused pain and trauma and the
child may be unhappy and uncooperative.
• Time spent gaining the child’s
confidence is a worthwhile investment.
• Syringing is often useful in children as it
is better tolerated, and the risk of causing
trauma is low.
• Once the foreign body has been removed
it is advisable to check the ears for
underlying pathology as the child may
have put in the foreign body due to itch,
pain or otorrhoea.
• COMPLICATIONS
• Complications may be caused
by the action of introducing the
foreign body or the foreign
body itself. In general, these
are limited to lacerations of the
canal skin and otitis externa.
• Rarely, facial nerve palsy may
occur secondary to leakage of
alkaline material from a button
battery and necrosis of the
surrounding tissue