Chrie Heparria U

Department Of Otorhinolaryngology Head And Neck Surgery

Faculty Of Medicine Sebelas Maret University /Dr Moewardi Hospital
Surakarta
2017
 A foreign body is an object or substance foreign to the location
where it is found
 The anatomical structure is one of the factor that has been
identified leading to difficulty removal of foreign body of ear.
(Baker, 2013)
• Removal of the foreign body Ear requires skill, and also high
accuracy. (Singh, 2007)
 FOREIGN BODY OF THE EAR PREDILECTION
Bone Bony
Auricle cartilaginous
junction
Osseous portion
Helix of ear canal

Tympanic
Membrane

Ear canal

Pinna Example
of a
Foreign
body
Heim & Maughan (2007) - photo; Jarvis (2008)

Cartilage
 animate (living)
(eg. insects, ants, ..) Organik (seeds,
Foreign cereals, foods..)
body
Inanimate
(nonliving)
Anorganik
(beads, small
stone, marbles)

Shrestha, 2012
INCIDENT

THE INCIDENT OF
STONE FOREIGN
BODY IS 4,54%

Qadir, 2015
 Physical examination :
On otoscopic examination,
we found that his external
auditory canal was lacerated
and swollen.

History : history of inserted of Supporting examination :

foreign body, Otalgia, hearing
loss,aural fullness Audiometri,CT Scan

DIAGNOSIS
TIMELINE
Name : Mr. L
age : 36 y.o February 13 2017

January 24 2017
Removing
Check to foreign body
December 26 Otorinologis using
2016 t clinicThe technique
Right ear first attempt post-auricular
pain, check to remove approach and
at general the foreign canaloplasty
physician body failed at RSDM

Refer to hospital
There Is No  Again a trial
improvement of removing
January 10 2017 foreign body
through the
natural external
canal did not
succeeded
January 27 2017
 Hearing loss,
pain, bleeding
a trial of
removing
foreign body
external through the
auditory natural
canal was external canal
lacerated and did not
Foreign body swollen, and succeeded
(stone) + granulation
inflammation founded
reaction
 On otoscopic examination, identify
the black foreign body.
 Hyperemic (+),

 Granulation tissue (+)

 discharge (-),

 Can not identify timpanic

membrane
 Tuning Fork Test
 Rinne + / +
 Weber referred to the right ear
(abnormal ear) Otoendoscopic Right Ear
 AD : Mild CHL (35 db)
 AS : Normal Hearing(11,25)
An isodens visualization with
appear in the right external
auditory canal suspected as
foreign body
Foreign Body In The Right Ear Canal
Remove the foreign body by a transcanal approached but
the external auditory canal was severely narrowed by the
inflammation, so then changed to a post-auricular
approach and canaloplasty

Additionally, canalplasty may be performed due

to poor intraoperative visualization of the
anterior sulcus of the external auditory canal

Foreign body visualization surround by

granulation tissue and a prominen EAC bone.

Posterior bony canal wall was drilled using

micro motor mastoid drill. So that space
available for delivering the foreign body and
was successfully removed
 Right Ear Auris Canal

discharge (-) , granulation tissue (-), intact

tympanic membrane, stenosis ear canal(-)
AD : Normal hearing
(23,75 db)
AS : Normal hearing
(17,25 db)
 Unsuccessful attempt to remove forein body in this
case may caused by
 granulation that surround the foreign body,
 external auditory canal was lacerated and edema,
because of the patient had did a failed attempt
previously in removal foreign body.
 Anatomical structure, we found a prominent body
canal ear not smooth there was a structure that looks
like spike. Then we did canaloplasty to enlarge the ear
canal.
• Removal of the foreign body Ear requires skill,
and also high accuracy.
• When the first attempt fails, referral to an
otolaryngologist is recommended and should be
attempted preferably in general anaesthesia along
with proper imaging studies at hand