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A child presenting with a bullet in the middle ear: case report
Patorn Piromchai1, Somchai Srirompotong, Piyawadee Lertchanaruengrith
1Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Insights
A bullet lodged in a child's ear canal was pushed into the middle ear during removal attempts. Successful retrieval required specialized otolaryngologist intervention, highlighting the need for careful foreign body removal.
Area of Science:
- Otolaryngology
- Emergency Medicine
- Pediatric Otology
Background:
- Foreign bodies in the external auditory canal are frequent occurrences in pediatric and adult populations.
- While typically removable in emergency departments, complications can arise from improper removal techniques.
- This case highlights a specific complication involving a metallic foreign body (bullet) pushed into the middle ear.
Observation:
- A 6-year-old boy presented with a bullet lodged in his external auditory canal.
- An initial removal attempt failed, leading to the bullet being displaced into the middle ear.
- Otoscopic findings revealed a ruptured tympanic membrane and granulation tissue in the middle ear.
Findings:
- The bullet was successfully removed from the middle ear via a post-auricular approach.
- The case illustrates a complication of foreign body removal in the ear canal.
Implications:
- Physicians must exercise caution during foreign body removal from the EAC to prevent iatrogenic injury.
- Referral to an otolaryngologist is crucial when initial removal attempts are unsuccessful.
- Prompt and expert intervention can mitigate risks of further trauma and middle ear complications.
Introduction:
Foreign bodies in the external auditory canal are common in both adults and children. Removal of the foreign body requires skill, but is usually successfully performed in the emergency department. We report a case of a child with a bullet in ear canal which was pushed into the middle ear during an attempt to remove it.
Case Presentation:
A 6-year-old Thai boy went to the community hospital with his parents, who reported that their child had pushed a bullet into his ear. Otoscopic examination revealed a metallic foreign body in his external auditory canal. The first attempt to remove the foreign body failed and the child was referred to an otolaryngologist. We found that the tympanic membrane was ruptured, with granulation tissue in the middle ear and the bullet was located in the hypotympanum. The foreign body was removed via a post-auricular approach.
Conclusion:
Removal of a foreign body from external auditory canal is an essential skill for physicians. Careful removal can prevent further trauma and complications. When the first attempt fails, referral to an otolaryngologist is recommended.
