Removal of foreign body from the external ear using the lasso technique

Aural foreign body removal: there is no one-size-fits-all method

Background

Managing patients with aural foreign body (AFB) may pose a dilemma regarding which removal technique to use for different AFB types. The current study comprises a review of all the possible methods one could employ in removing AFB. My aim was to describe the best methods for different types of AFBs, complete with a description of the method and tool(s) required, and descriptions of the AFBs for which they are best used.

Materials and methods

The medical literature published between 2000 and 2016 was reviewed using Medline, Cinahl, Embase, Cochrane, PubMed, and Scopus to compile a list of all published AFB removal methods.

Results

Ten methods were identified and described, each having their own advantages for different AFBs. Patients normally permit very few attempts, so the first AFB removal attempt should ideally be the only one.

Conclusion

There is no single method guaranteed to work with all AFBs, so this report also contains a flowchart to aid deciding which technique to use.

Esophageal wishbone extraction: not for the chicken-hearted

OBJECTIVE

Ingestion of foreign bodies in the pediatric population is common and in the majority of cases involves spontaneous passage through the esophagus; however, they can become lodged in spaces of anatomical narrowing. Sharp foreign bodies are of particular concern due to a higher chance of perforation and other complications. The goal of this case report is to describe the safe removal of a chicken wishbone and 3 alternate options in the event that the initial choice was unsuccessful.

METHODS

We report the case of a 2-year-old boy who presented to our pediatric tertiary center after unsuccessful endoscopic removal of a chicken wishbone from the esophagus.

RESULTS

Radiologically, the wishbone was oriented with the tines pointing up. Endoscopic examination revealed the tips of both tines to be embedded deeply into the lateral walls of the esophageal mucosa. Esophagoscopy and protecting the sharp points of the wishbone were used to successfully extract the intact wishbone.

CONCLUSION

Previous techniques have involved cutting the bone; however, in this case, tension was so high that it was felt that cutting the bone would result in perforation. Proper management of such cases requires planning and often multiple strategies.