Foreign bodies in the ear, nose, and airway

Foreign bodies in the ear, nose, and breathing tract (airway) sometimes occur in children. Foreign bodies refer to any object that is placed in the ear, nose, or mouth that is not meant to be there and could cause harm without immediate medical attention.

Facts about foreign bodies in the ear, nose, and airway:

• Foreign bodies in the ear, nose, and airway are most common in children under the age of 5 years. These require emergent medical attention. Foreign bodies in the airway constitute a medical emergency and require immediate attention.
• Foreign bodies in the breathing tract may cause suffocation and death. This is one of the leading causes of unintentional death in the home, especially among children under the age of 5 years.
• Foreign bodies in the ear canal are found most often in children between the ages of 2 and 4 years.

Foreign bodies in the ear:

Foreign bodies can either be in the ear lobe or in the ear canal. Objects usually found in the ear lobe are earrings, either stuck in the lobe from infection or placed too deep during insertion. Foreign bodies in the ear canal can be anything a child can push into their ear. Some of the items that are commonly found in the ear canal include the following:

• Food
• Insects
• Toys
• Buttons
• Pieces of crayon
• Small batteries

It is important for parents to be aware that children may cause themselves or other children great harm by placing objects in the ear.

The reason children place things in their ears is usually because they are bored, curious or copying other children. Sometimes, one child may put an object in another child's ear during play. Insects may also fly into the ear canal, causing potential harm. It has also been noted that children with chronic outer ear infections tend to place things in their ears more often.

What are the symptoms of foreign bodies in the ear?

Some objects placed in the ear may not cause symptoms, while other objects, such as food and insects, may cause pain in the ear, redness, or drainage. Hearing may be affected if the object is blocking the ear canal.

Treatment for foreign bodies in the ear:

The treatment for foreign bodies in the ear is prompt removal of the object by your child's physician. The following are some of the techniques that may be used by your child's physician to remove the object from the ear canal:

• Instruments may be inserted in the ear
• Magnets are sometimes used if the object is metal
• Cleaning the ear canal with water
• A machine with suction to help pull the object out

Some objects which are deep in the ear canal may need to be removed in the operating room.

• Suction machines with tubes attached
• Instruments may be inserted in the nose

After removal of the object, your child's physician may prescribe nose drops or antibiotic ointments to treat any possible infections.

Foreign bodies in the airway:

Foreign bodies in the airway constitute a medical emergency and require immediate attention. The foreign body can get stuck in many different places within the airway. Foreign bodies in the airway account for nearly 9 percent of all home accidental deaths in children under 5 years of age.

As with other foreign body problems, children tend to put things into their mouths when they are bored or curious. The child may then inhale deeply and the object may become lodged in the "airway" tube (trachea) instead of the "eating" tube (esophagus). Food may be the cause of obstruction in children who do not have a full set of teeth to chew completely or those children who simply do not chew their food well. Children also do not have complete coordination of the mouth and tongue which may also lead to problems. Children between the ages of 7 months and 4 years are in the greatest danger of choking on small objects, including, but not limited to, the following:

• Seeds
• Toy parts
• Grapes
• Hot dogs
• Pebbles
• Nuts
• Popcorn
• Buttons

Children need to be watched very closely to avoid a choking emergency.

What are the symptoms of foreign bodies in the airway?

Foreign body ingestion requires immediate medical attention. The following are the most common symptoms that may indicate a child is choking. However, each child may experience symptoms differently. Symptoms may include:

• Choking or gagging when the object is first inhaled
• Coughing at first
• Wheezing (a whistling sound, usually made when the child breathes out)

Although the initial symptoms listed above may subside, the foreign body may still be obstructing the airway. The following symptoms may indicate that the foreign body is still causing an airway obstruction:

• Stridor (a high pitched sound usually heard when the child breathes)
• Cough that gets worse
• Child is unable to speak
• Pain in the throat area or chest
• Hoarse voice
• Blueness around the lips
• Not breathing
• The child may become unconscious

Treatment for foreign bodies in the airway:

Treatment of the problem varies with the degree of airway blockage. If the object is completely blocking the airway, the child will be unable to breath or talk and their lips will become blue. This is a medical emergency and you should seek emergency medical care. Sometimes, surgery is necessary to remove the object. Children that are still talking and breathing but show other symptoms also need to be evaluated by an ENT immediately.