Fig. 396
Complete destruction of auricle by rodent ulcer. (Buffalo Clinic.)
Fig. 397
Congenital lymphangioma of ear. (Lexer.)
FOREIGN BODIES IN THE EAR.
All sorts and descriptions of foreign bodies may enter the ear. Young children have a tendency to introduce all kinds of bodies into the ear, as into the nose, and sometimes intrude them to such a distance that their removal is made difficult. Living insects make their way into the meatus auditorius and even deposit their larvæ, which may subsequently go through their developmental phases and fill the passage-way with young insects. Among the inanimate materials which children introduce are small buttons, pebbles, beans, peas, beads, etc. Such a foreign body may not be at once discovered, and some of those which easily undergo decomposition, like fresh vegetable substances, may not be detected until they have set up trouble by decomposition. Therefore it may be hours or days before its presence is recognized. Sometimes it may be easily seen, again it may be concealed. When the auricle is drawn upward and backward the external meatus is somewhat straightened, and bodies within it are more easily made visible, especially by reflected light. Therefore the head mirror is usually required for their detection and removal. The substance may be one which is easily seized and withdrawn, after certain turning or shifting motions have been attempted, or it may be impacted so as to offer considerable difficulties. It should never be pushed farther in, for injury might thus be done to the membrana tympani, and the effort should be to remove it with the least possible damage to the lining of the canal. So essential is it to have the head kept perfectly still during these maneuvers that it will be advisable, with young children, to administer an anesthetic. Instances occasionally occur which necessitate incision and liberation of the auricle, with its deflection forward, and the consequent more complete exposure of the auditory canal. Forceps of various fashions may be used, or occasionally a blunt hook may be made with a probe, which may be used to advantage.
Of living foreign bodies information can be obtained more promptly, as the annoyance caused by their movements will at once disturb the patient.
Relief has often been promptly afforded by filling the meatus with water or glycerin as warm as can be borne, by which the insect is killed, after which it may be removed by irrigation or by forceps, assisted by good illumination.