Insect
Instil 1% lignocaine in to ear to kill and relieve sensation. Do NOT remove with forceps as most insets break apart. Best option is careful suction (never lose sight tip suction catheter) or lavage.
Hard FB’s
First may be the only chance you get in children:
Refer ENT if spherical object up against tympanic membrane
Otherwise:
- Curette retrieval (curved, hook)
- Irrigation (water)
- Forceps
- Super-Glue (cyanoacrylate)
- Suction catheter
Cyanoacrylate
- Limited shelf life (may harden in the tube)
- Gel better than liquid
- Soluble in acetone
- Does not stick well to wood or metal
- Method
- Put a drop on the end of a plastic stick
- Touch the stick to the FB, wait for it to stick
- Pull it straight out
- Do not try on uncooperative patients
Acetone can be used to dissolve Styorfoam objects (or cyanoacrylate).