Foreign Bodies in the Ear, Nose, and Throat

In can be scary when an infant or young child puts an object in their ears, nose, or mouth. Objects in the mouth may be swallowed or breathed into (aspirated) the lungs. A swallowed object may pass through the body with no problems, but still call your healthcare provider. Your child may need to be seen.

If your child is choking on it, emergency care is needed. Call 911. In some cases, the child may need general anesthesia and a procedure to remove it. Aspiration can cause breathing problems and require emergency treatment. Objects in the ears and nose can make it hard to hear or breathe and can cause infection.

Foreign bodies in the ear

Foreign bodies in the ear canal can be anything a child can push into the ear. Some of the items that are commonly found in the ear canal include:

• Food

• Insects

• Toys

• Buttons

• Pieces of crayon

• Small batteries

Some objects placed in the ear may not cause symptoms. 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.

The treatment for foreign bodies in the ear is prompt removal of the object by your child's healthcare provider. The following are some of the ways your child's healthcare provider may treat an object in the ear:

• Instruments such as long, thin tweezers or forceps may be put in the ear to grab and remove the object.

• Magnets are sometimes used to remove the object if it is metal.

• The ear canal may be flushed with water.

• A machine with suction may be used to help pull the object out.

After removal of the object, your child's healthcare provider will then re-examine the ear to determine if there has been any injury to the ear canal or ear drum. Antibiotic drops for the ear may be prescribed to treat any possible outer ear infections.

Foreign bodies in the nose

Objects that are put into the child's nose are usually soft things. These would include:

• Tissue

• Clay

• Pieces of toys

• Erasers

Sometimes, a foreign body may enter the nose while the child is trying to smell the object.

The most common symptom of a foreign body in the nose is nasal drainage. The drainage appears only on the side of the nose with the object and often has a bad odor. In some cases, the child may also have a bloody nose.

Treatment of a foreign body in the nose involves quick removal of the object by your child's healthcare provider. Sedating the child is sometimes needed. These are some of the ways your child's healthcare provider may use to remove the object from the nose:

• Suction machines with tubes attached may be used.

• Instruments may be inserted in the nose.

• The object may be "blown" out of the nose. You may be asked to hold the unaffected nostril shut and place your mouth directly over your child's mouth as if you were giving mouth-to-mouth resuscitation. With your child's mouth open, you can quickly and forcibly blow into their mouth. The pressure will go through the mouth, up into blocked nasal passage, and can often "blow" the object out.

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

Foreign bodies in the throat

A foreign body in the throat can cause choking and is a medical emergency that needs immediate attention. The foreign body can get stuck in many different places within the airway. 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 block the throat in children who don't have a full set of teeth to chew completely, or those children who simply don't chew their food well. Children also don't have complete coordination of the mouth and tongue, which may also lead to problems. Children under the age of 4 years are in the greatest danger of choking on small objects, including:

• Seeds

• Toy parts

• Grapes

• Hot dogs

• Pebbles

• Chunks of raw vegetables

• Nuts

• Buttons, button-cell batteries

• Coins

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

Foreign body ingestion needs immediate medical attention. The following are the most common symptoms that may mean a child is choking:

• 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 resolve, the foreign body may still be blocking the airway. The following symptoms may mean that the foreign body is still blocking an airway:

• Stridor (a high-pitched sound usually heard when the child breathes)

• Cough that gets worse

• Child can't speak

• Pain in the throat area or chest

• Hoarse voice

• Blueness around the lips

• Not breathing

• The child becoming unconscious

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 breathe or talk and their lips will become blue. This is a medical emergency and you should seek emergency medical care. Do basic life support treatment for choking if you have been trained. Sometimes, surgery is needed to remove the object. Children who are still talking and breathing but show other symptoms also need to be evaluated by a healthcare professional right away.

To prevent choking:

• Cut foods into small pieces.

• Never let small children run, play, or lie down while eating.

• Keep coins and small items out of reach of your children.

• Make sure older children don't give younger children things that they can choke on.

• Read warning labels on toys.

• Learn first aid for choking.