Children and Foreign Bodies in the Ear, Nose, and Airway
It’s a well-known fact among parents that children sometimes put things in their ears, nose, or mouth that may cause harm if immediate medical attention is not provided. Often, caregivers are unaware that a child has taken in such an object and this makes getting the right treatment more difficult.
The symptoms caused by these objects range from discomfort and pain to decreased hearing, changes or noises from breathing, difficulty swallowing, and sometimes drainage especially from objects in the ear or nose. If there is difficulty breathing, the object could cause serious problems and immediate action should be taken to see the appropriate doctor.
Doctors call these objects foreign bodies. A recent medical study has shown that with some people it is hard to see certain types of foreign bodies with the naked eye. It is recommended that “these cases be referred directly to otolaryngologists for otomicroscopic removal or removal with special light scopes.” In other words, an ear, nose, and throat specialist physician should remove such objects to avoid further harm.
Facts about foreign bodies in the ear, nose, and airway
- Children under age five are the most likely to ingest foreign bodies in the ear, nose, or airway. But teenagers and irresponsible adults have been known to engage in such activities though most occurrences are accidental.
- Foreign bodies in the ear canal are found most often in children between the ages of two and four.
- Airway obstruction from foreign bodies may cause suffocation and death. This accounts for nearly 9 percent of accidental deaths in the home, especially among children under the age of five years.
- About five percent of all children swallow coins, and a coin-swallowers’ average age is three.
Foreign bodies in the ear
Children usually place things in their ear canal because they are bored, curious, or copying other children or during play one child may put an object in another’s ear. Parents should be aware that children may cause harm to themselves or other children by placing objects in the ear. There may also be a direct link between chronic outer ear infections and children who tend to place things in their ears. Any child with a chronically draining ear should be evaluated for a foreign body.
Items that are commonly found in the ear (usually the canal) of younger children include food, insects, toys, buttons, pieces of crayon, and small button-shaped batteries. Teenagers sometimes have objects imbedded in the ear lobe due to an infection from a pierced ear or a poorly healed piercing.
Treatment for foreign bodies in the ear
The treatment for foreign bodies in the ear is removal of the object by your child’s physician. Some techniques your child’s physician may use to remove a foreign body include: instruments inserted into the ear to remove the foreign body; magnetic instruments used if the object is metal; cleaning the ear canal with water; filling the ear with mineral oil to suffocate an insect; or using a suction machine to help pull the object out.
After removal of the object, your child’s physician will then re-examine the ear to determine if there has been any injury to the ear canal. Antibiotic drops for the ear may be prescribed to treat any possible infections.
Foreign bodies in the nose
Objects that are put into the child’s nose are usually, but not always, soft things like tissue, clay, and pieces of toys or erasers. Harder objects, much like those commonly put in the ear, are sometimes put into the nose. From time to time, a foreign body may enter the nose while the child is trying to smell the object.
What are the symptoms of foreign bodies in the nose?
The most common symptom of a foreign body in the nose is nasal drainage. The drainage often has a bad odor. Parents should suspect a foreign body and not a “cold” when drainage is from only one nostril. In some cases, the child may also have a bloody nose.
Treatment for foreign bodies in the nose
Foreign objects in your child’s nose should be removed promptly. Sedating the child is sometimes necessary in order to remove the object successfully. This may have to be performed in the hospital, depending on the extent of the problem and the cooperation of the child. The following are some of the techniques that may be used by your child’s physician to remove the object from the nose: suction machines with tubes attached; or forceps, which act like small tweezers to remove the object.
After removal of the object, your child’s physician may re-examine the nose with a special fiber optic light looking for another foreign body or may prescribe nose drops or antibiotic ointments to treat any possible infections.
Foreign bodies in the airway
Children put many things in their mouths (including food) that can cause trouble. When you know that a child has ingested a foreign object, consider this a medical emergency and seek immediate attention. If your child is choking—cannot breathe, gasping, cannot talk, or is turning blue-call 911 or an ambulance in case your efforts to help are unsuccessful. Parents should watch for these commonly ingested items: pebbles, hotdogs, grapes, seeds, nuts, toy parts, coins (especially newer pennies), small button-shaped batteries, buttons, and marbles.
Aside from choking, trouble may happen when the object becomes lodged in the “airway” tube (trachea) instead of the “eating” tube (esophagus) and his/her distress is harder to see. Children may experience symptoms differently; some children may even have vague symptoms that do not immediately suggest ingestion. While most swallowed foreign objects pass harmlessly through the esophagus, the stomach, and intestines, a foreign body may also cause harm if it has associated toxicity or becomes lodged in the gastrointestinal tract.
Parents should suspect their child might have swallowed a foreign object if breathing or swallowing difficulties persist longer than two weeks despite medical treatment for example, continuing asthma or upper or upper respiratory treatment without seeing improvement. If you know that your child has swallowed a foreign object look for these symptoms of choking first, and then look next for signs of obstruction: Choking and or obstruction-not breathing, unconscious; choking or gagging when the object is first inhaled; child is unable to speak; or blueness around the lips.
The following symptoms may indicate that although the child is not choking, 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, unconscious; or an unexplained fever.
If you are fairly sure that a foreign body has been swallowed and your child is not experiencing an airway obstruction, continue to watch for the following gastrointestinal blockage symptoms: GI obstruction symptoms: abdominal distention/pain; vomiting; blood in the stool; or an unexplained fever. Toxicity: Other consequences of ingestion may cause problems as well. Coins (for instance newer copper-coated zinc pennies) and batteries may cause system-wide reactions because some metals are extremely toxic and may cause inflammation.
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 his/her 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 a physician immediately.
If you child is unconscious, lay the child on the floor on his/her back. Place your hand on the child’s abdomen and placing your other hand over it, press upon the abdomen four times. This should release the object that is obstructing the airway. Repeat these life saving procedures until the ambulance arrives. Make sure you tell the medical team immediately what caused the child to choke or what obstructs the breathing so that proper treatment can be administered.
2004 American Academy of Otolaryngology - Head and Neck Surgery
- back to top -