[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Foreign bodies of the ear and nose

[Conditions](https://durgical.com/en/conditions/) · [Ophthalmology and ENT](https://durgical.com/en/conditions/)

# Foreign bodies of the ear and nose

Objects or insects stuck in the [ear canal](https://durgical.com/en/anatomy/external-acoustic-meatus/) or nose, very common in small children. Button batteries and magnets are emergencies because they burn tissue.

Updated 2026-11-01

## Structures involved

Tap one to see what it is and open it in 3D.

- [Ear canal](https://durgical.com/en/anatomy/external-acoustic-meatus/)
- [Nasal cavity](https://durgical.com/en/anatomy/nasal-cavity/)
- [Eardrum](https://durgical.com/en/anatomy/tympanic-membrane/)
- [Auricle](https://durgical.com/en/anatomy/auricle/)
- [Nasal septum](https://durgical.com/en/anatomy/nasal-septum/)
- [Inferior nasal conchae](https://durgical.com/en/anatomy/inferior-nasal-concha-bone/)
- [Nasal cartilages](https://durgical.com/en/anatomy/major-alar-cartilage/)

## What it is

An object placed in or entering the external ear canal or the [nasal cavity](https://durgical.com/en/anatomy/nasal-cavity/). Children usually insert beads, seeds, toy parts, paper, food or erasers; insects can crawl into the ear at any age. Most are harmless if removed correctly, but button batteries, paired magnets and swelling organic material cause rapid damage. Airway aspiration is a separate problem handled elsewhere.

## Who gets it

A frequent reason for paediatric emergency and ENT visits, mostly in children aged 1 to 6. In adults, ear foreign bodies are often cotton-bud tips or insects, and in people with intellectual disability or psychiatric illness insertion may be repeated. In rural and tropical areas of Colombia, live insects and myiasis (fly larvae) are a recognised cause.

## Causes

- Inorganic: beads, toy parts, stones, buttons, button batteries, magnets, cotton tips
- Organic: seeds, beans, grains, food, paper and sponge, which swell with moisture
- Live insects (cockroaches, flies, ants, moths), mostly in the ear
- Fly larvae in neglected wounds or atrophic nasal disease

## Risk factors

- Age 1 to 6 and curiosity, play with small objects
- Developmental delay, autism or psychiatric illness
- Cleaning the ears with cotton buds or other objects
- Sleeping on the ground or in poor housing (insects)
- Access to button batteries and small magnets in toys and devices

## Pathophysiology

In the ear canal, the bony medial part is narrow and very sensitive; objects lodge at the isthmus, and attempts at removal push them toward the eardrum. In the nose, objects usually lie on the floor under the inferior turbinate or in front of the middle turbinate, block one side and cause mucosal inflammation and infection with foul unilateral discharge. A button battery produces an electrical current and alkaline injury that destroys mucosa within hours, causing septal perforation or ear canal and eardrum damage; magnets placed in both nostrils compress the septum and cause necrosis.

## Classification

- By site: external ear canal or nasal cavity
- By material: inorganic, organic (hygroscopic), live insect, button battery or magnet
- By urgency: emergency (battery, magnets, airway risk) or non-urgent

## Symptoms and signs

- Ear: often none; or pain, a feeling of fullness, hearing loss, itching or bleeding
- Ear with a live insect: buzzing, intense discomfort and anxiety
- Nose: one-sided nasal obstruction
- Nose: unilateral, foul-smelling, purulent or blood-stained discharge in a child, which is a foreign body until proven otherwise
- Nosebleeds or bad breath
- Sometimes the child or a witness reports inserting the object

## Red flags

- Button battery or magnets in the nose or ear: removal within hours
- Difficulty breathing, stridor or coughing (possible aspiration of a displaced nasal object)
- Eardrum perforation, vertigo, facial weakness or bloody discharge after removal attempts
- Sharp objects
- Repeated unexplained foreign bodies (consider neglect or developmental issues)

## Diagnosis

**Clinical**
Otoscopy or anterior rhinoscopy with good light, a nasal speculum or an otoscope speculum in the nostril. Both ears and both nostrils are examined, since children often insert more than one object. The [eardrum](https://durgical.com/en/anatomy/tympanic-membrane/) is examined after removal.

**Tests**
None routinely. Nasal endoscopy in the ENT clinic if the object is not seen.

**Imaging**
X-ray when a metallic object or button battery is suspected but not visualised, and to look for objects that may have been swallowed or aspirated; a battery shows a double ring (halo) sign. CT if a complication is suspected.

## Differential diagnosis

- Acute otitis externa or impacted earwax
- Acute otitis media
- Unilateral rhinosinusitis or nasal polyp
- Choanal atresia (unilateral discharge from birth)
- Nasal tumour (rare in children)

## Goal of treatment

Remove the object safely at the first attempt, avoid pushing it deeper or causing injury, and treat any damage or infection.

## Treatment

**Acute**
Emergency removal of button batteries and magnets; never irrigate when a battery is suspected; do not wait for symptoms.

**Procedure**
Nose: positive-pressure techniques such as the parent's kiss (the parent blows into the child's mouth while closing the clear nostril), then removal with a hook, forceps or suction under direct vision, after a topical vasoconstrictor and anaesthetic.

**Procedure**
Ear: removal under direct vision with a microscope, right-angle hook, forceps or suction; irrigation for small inorganic objects when the eardrum is intact, never for organic objects that swell or for batteries.

**Acute**
Live insect in the ear: first kill it by filling the canal with mineral oil or lidocaine, then remove it.

**Surgical**
Removal under general anaesthesia when the child is uncooperative, the object is deep or previous attempts failed.

**Medical**
Topical or systemic antibiotics for secondary infection, and follow-up of mucosal or eardrum injury.

## Complications

- Ear canal lacerations, bleeding and eardrum perforation, mostly from removal attempts
- Otitis externa
- Nasal septal perforation and synechiae, especially after button batteries
- Sinusitis
- Aspiration of a nasal object into the airway
- Rhinolith (calcified long-standing nasal foreign body)

## Prognosis

Excellent when removed promptly by experienced hands. Delayed button battery removal can leave permanent septal perforation or ear damage.

## Prevention

- Keep small objects, button batteries and magnets out of children's reach; secure battery compartments
- Avoid inserting cotton buds or other objects into the ear
- Insect control and sleeping off the floor in rural housing
- Health education for caregivers on what to do and not to do

## Test yourself

Think of the answer, then tap the question to see it.

## A 3-year-old has foul-smelling discharge from one nostril for 2 weeks. Most likely cause?

A nasal foreign body.

## Which ear or nose foreign body requires emergency removal?

A button battery (also paired magnets in the nose).

## Why should a bean in the ear not be irrigated?

Organic material absorbs water, swells and becomes harder to remove.

## First step for a live insect in the ear canal?

Kill it with mineral oil or lidocaine before removing it.

## Positive-pressure technique often used first for nasal foreign bodies in children?

The parent's kiss (mouth-to-mouth puff with the clear nostril occluded).

[Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/foreign-bodies-of-the-ear-and-nose/)

## Related conditions

- [Otitis externa](https://durgical.com/en/conditions/otitis-externa/)
- [Acute otitis media](https://durgical.com/en/conditions/acute-otitis-media/)
- [Hearing loss (conductive and sensorineural, including sudden hearing loss)](https://durgical.com/en/conditions/hearing-loss/)
- [Epistaxis (nosebleed)](https://durgical.com/en/conditions/epistaxis/)
- [Acute rhinosinusitis](https://durgical.com/en/conditions/acute-rhinosinusitis/)
- [Chronic rhinosinusitis and nasal polyps](https://durgical.com/en/conditions/chronic-rhinosinusitis-and-nasal-polyps/)
- [Tungiasis and furuncular myiasis](https://durgical.com/en/conditions/tungiasis-and-furuncular-myiasis/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Foreign body in the nose](https://medlineplus.gov/ency/article/000037.htm) (MedlinePlus, US National Library of Medicine, 2026); [Ear emergencies](https://medlineplus.gov/ency/article/000052.htm) (MedlinePlus, US National Library of Medicine, 2026).

[← All conditions](https://durgical.com/en/conditions/)

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/conditions/foreign-bodies-of-the-ear-and-nose/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/foreign-bodies-of-the-ear-and-nose/