Foreign Bodies in the Ear, Nose, and Throat

An infant or young child may put an object in his or her ears, nose, or mouth. Objects in the mouth may be swallowed or breathed (aspirated) into the lungs. Objects in the ears and nose can make it difficult to hear or breathe and can cause infection. An object that is swallowed may need general anesthesia and a procedure to remove it. An object that is aspirated may cause serious difficult breathing and needs a procedure for removal.

Foreign bodies in the ear

Foreign bodies in the ear canal can be anything a child can push into his or her ear. Some of the items that are commonly found in the ear canal include the following:

• Food

• Insects

• Toys

• Buttons

• Pieces of crayon

• Small batteries

Some objects placed in the ear may not cause symptoms. Other objects, such as food and insects, may cause pain in the ear, redness, or drainage. Hearing may be affected if the object is blocking the ear canal.

The treatment for foreign bodies in the ear is prompt removal of the object by your child's healthcare provider. The following are some of the techniques that may be used by your child's healthcare provider to remove the object from the ear canal:

• Instruments may be inserted in the ear

• Magnets are sometimes used if the object is metal

• Flushing the ear canal with water

• A machine with suction to help pull the object out

After removal of the object, your child's healthcare provider will then re-examine the ear to determine if there has been any injury to the ear canal. Antibiotic drops for the ear may be prescribed to treat any possible infections.

Foreign bodies in the nose

Objects that are put into the child's nose are usually soft things. These would include:

• Tissue

• Clay

• Pieces of toys

• Erasers

Sometimes, a foreign body may enter the nose while the child is trying to smell the object.

The most common symptom of a foreign body in the nose is nasal drainage. The drainage appears only on the side of the nose with the object and often has a bad odor. In some cases, the child may also have a bloody nose.

Treatment of a foreign body in the nose involves prompt removal of the object by your child's healthcare provider. Sedating the child is sometimes necessary in order to remove the object successfully. The following are some of the techniques that may be used by your child's healthcare provider to remove the object from the nose:

• Suction machines with tubes attached

• Instruments may be inserted in the nose

After removal of the object, your child's healthcare provider may prescribe nose drops or antibiotic ointments to treat any possible infections.

Foreign bodies in the throat

A foreign body in the throat can cause choking and is a medical emergency and needs immediate attention. The foreign body can get stuck in many different places within the airway. According to the American Academy of Pediatrics, death by choking is a leading cause of death and injury among children younger than 4 years of age. 

As with other foreign body problems, children tend to put things into their mouths when they are bored or curious. The child may then inhale deeply and the object may become lodged in the "airway" tube (trachea) instead of the "eating" tube (esophagus). Food may be the cause of obstruction in children who do not have a full set of teeth to chew completely, or those children who simply do not chew their food well. Children also do not have complete coordination of the mouth and tongue, which may also lead to problems. Children under the age of 4 years are in the greatest danger of choking on small objects, including:

• Seeds

• Toy parts

• Grapes

• Hot dogs

• Pebbles

• Nuts

• Buttons

• Coins

Children need to be watched very closely to avoid a choking emergency.

Foreign body ingestion needs immediate medical attention. The following are the most common symptoms that may indicate a child is choking:

• Choking or gagging when the object is first inhaled

• Coughing at first

• Wheezing (a whistling sound, usually made when the child breathes out)

Although the initial symptoms listed above may subside, the foreign body may still be obstructing the airway. The following symptoms may indicate that the foreign body is still causing an airway obstruction:

• Stridor (a high-pitched sound usually heard when the child breathes)

• Cough that gets worse

• Child is unable to speak

• Pain in the throat area or chest

• Hoarse voice

• Blueness around the lips

• Not breathing

• The child may become unconscious

Treatment of the problem varies with the degree of airway blockage. If the object is completely blocking the airway, the child will be unable to breathe or talk and his or her lips will become blue. This is a medical emergency and you should seek emergency medical care. Sometimes, surgery is necessary to remove the object. Children who are still talking and breathing but show other symptoms also need to be evaluated by a healthcare professional immediately.

To prevent choking:

• Cut foods into small pieces

• Never let small children run, play, or lie down while eating

• Keep coins and small items out of reach of your children

• Read warning labels on toys

• Learn first aid for choking