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Managing the Destructive Foreign Body: Water Beads in the Ear (A Case Series) and Literature Review
Habib G Zalzal1, Matthew Ryan1,2, Brian Reilly1
1Department of Otolaryngology, Children's National Medical Center, Washington, DC, USA.
Objective:
To characterize our experience with super-absorbent polymer beads placed in the external auditory canal to better understand the damage caused and subsequent management required.
Methods:
Retrospective chart review of pediatric patients at 2 separate tertiary referral centers.
Results:
Seven patients were identified as having placed super-absorbent polymer beads in the external auditory canal, 6 of whom required removal under general anesthesia. Three patients did not suffer otologic trauma or hearing loss (average foreign body duration <72 hours). Four patients experienced severe otologic complications (average foreign body duration >1 week), all of whom were treated with otologic drops prior to bead identification. Of this severe complication group, 3 patients had restored hearing after surgical intervention, while 1 patient suffered profound hearing loss secondary to labyrinthitis ossificans.
Conclusion:
Early recognition of otologic foreign bodies is important, particularly if expansile water-bead is suspected. Depending on timeframe, water beads are highly destructive to the middle ear structures, and most patients will require surgical intervention.
