Ear Trauma and Foreign Bodies

Ear trauma and aural foreign bodies span an unusually wide clinical range. Most are genuinely minor — a bead in a toddler's canal, a small traumatic perforation that heals itself. A few are emergencies where delay causes permanent harm, and one — the button battery — can destroy tissue within hours. Three principles organize the whole topic, and each one is about restraint. First: never instrument blindly. The commonest serious harm in aural foreign body management is iatrogenic — inflicted by well-meaning attempts at removal. Repeated blind grabbing with forceps pushes objects deeper, lacerates the canal, perforates the tympanic membrane and turns a simple outpatient removal into a theatre case under general anaesthetic. One skilled attempt under direct vision beats three hopeful ones. Second: irrigation is not universally safe. It is a reasonable technique for some objects, and it is contraindicated for others — suspected perforation, tympanostomy tubes, button batteries, and organic material that swells. Reaching for a syringe without asking what the object is and whether the drum is intact is a recognized route to injury. Third: the ear...