Required Instruments
- Otoscope [Figure 80].
- Ear speculum with a tip diameter of 6 mm.
- Hook.
- Nasal speculum.
- Head lamp.
Figure 80
Patients with a foreign object in their auditory meatus or the nasal cavity are often children, elderly people, and those with mental disabilities. When the foreign object is stuck in the nasal cavity, the patient may be panicking because breathing is affected. In such cases, the procedure sometimes has to be conducted under a light general anaesthetic in hospital.
Procedure
- The patient sits on a chair with good back support.
- Sit on a height-adjustable stool beside or in front of the patient.
- Your eyes should be at the same height as the patient’s ear.
- Ensure that all required materials are ready for use.
- Apply the ear speculum to your otoscope.
- Ask the patient or their guardian to hold the upper ridge of the auricle, and to pull it in a postero-superior direction [Figure 81].
Figure 81
- Slide the retractable lens of the otoscope far enough to the side to allow the hook to pass alongside [Figure 82].
- Looking through the speculum, carefully insert it into the auditory meatus with your non-dominant hand.
- With your dominant hand, insert the hook with the opened part positioned horizontally, via the speculum.
- When you are underneath the object, carefully try to turn the hook into an upwards vertical position. If this is not successful carefully move marginally further into the ear and try again.
- The latter should be done very carefully. You will not be able to see the tympanic membrane and you could damage it if you move too far.
Figure 82
- Once you are able to turn the hook vertically, carefully pull it out of the ear, thereby removing the foreign object.
- Finally, check the external auditory meatus and the tympanic membrane to see if anything is damaged which may need treatment.
