Chronic discharging ear in a child: are we missing something?

Area of Science:

• Otolaryngology
• Pediatric Medicine
• Medical Case Reports

Background:

• Chronic discharging ear is common in children in developing nations, often due to infection.
• Forgotten middle ear foreign bodies are a rare but significant cause, requiring high clinical suspicion.
• Most foreign bodies are removed via the permeatal approach; tympanotomy is infrequently documented.

Purpose of the Study:

• To report a rare case of a child self-introducing a large stone into the middle ear.
• To highlight the diagnostic challenge posed by forgotten foreign bodies.
• To document the use of tympanotomy for pediatric middle ear foreign body removal.

Main Methods:

• A case study of a child presenting with chronic discharging ear.
• Diagnostic evaluation including otoscopy.
• Surgical removal of the foreign body via tympanotomy.

Main Results:

• A large stone was identified as the foreign body within the middle ear, introduced through a tympanic membrane perforation.
• Successful removal of the foreign body was achieved using tympanotomy.
• This represents the first reported case of a child self-inserting a stone and the second pediatric tympanotomy for foreign body removal.

Conclusions:

• Forgotten middle ear foreign bodies, though rare, should be considered in pediatric chronic ear discharge.
• Tympanotomy is a viable, albeit uncommon, surgical option for removing large or impacted middle ear foreign bodies in children.
• Early diagnosis and appropriate management are crucial to prevent complications.