“Nothing Smaller Than Your Elbow”: When Kids Put Things in Their Ears

Did you ever hear this phrase from your grandmother? It refers to what it is OK to put in your ear and clearly implies that nothing actually belongs in your ear. And whose kid hasn’t come close or (worse yet) succeeded in putting something in the ear that simply does not belong there? Popular items seem to be beads, erasers, popcorn kernels and beans. And all of them need to be removed.

So if prevention fails, what must parents do?

  1. Understand that some items are far more dangerous and require immediate attention. The most notable example of a serious danger to the child is a “button” battery–those small round batteries that seem to power just about everything these days. They are all around us and consequently present a constant threat. A button battery in any body opening is a medical emergency. These should be removed by an ENT specialist (or Emergency Department (ED) doctor if an ENT is not immediately available) as soon as possible. It is important that these batteries not be removed through the use of irrigation techniques.
  2. Items that need removal but are far less dangerous are the “run of the mill” plastic beads, erasers or popcorn kernels. They are irritating but can be taken out the following day if the event occurs late in the afternoon or evening.
  3. What is the best method for removal?
    a.  Regardless of who is trying to remove the object, the best chance for success is the first try. This requires appropriate tools and expertise, especially with the more difficult smooth and round objects or those with a pointy ends–especially if the point is directed towards the eardrum. An ENT doctor will use a microscope and specialized instruments used in ear surgery to get around these objects and pull them out. If “tweezers” or other instruments are used on objects that cannot be “grasped” there is danger of pushing the object further into the ear canal, damaging the eardrum and causing bleeding and/or swelling of the ear canal. And it HURTS!! This, in turn, makes the second try far more difficult and occasionally necessitates a trip to the operating room.
    b.  Pieces of paper, foam rubber or “the innards” from sofas or loved stuffed animals are far easier to grasp and remove and can often be done by the primary care provider or ED.

Although not considered a foreign body, Q-tips are indeed smaller than your elbow. Despite our love affair with these “indispensable bathroom tools,” Q-tips actually represent a serious danger to children.  Ear wax is actually not dirty, should not be excessively cleaned and most of the time is self-cleansing. Q-tips can easily traumatize the ear canal and sometimes result in a tympanic membrane perforation (hole in the eardrum) and hearing loss that may require a major surgical procedure for repair of the damage. Seeing blood coming from your child’s ear is never a pleasant experience and the guilt associated with this trauma lives on for quite some time for many parents. These traumas easily occur when the child moves while the parent is attempting to clean the ear or when the child learns that Q-tips go in the ear and an accident occurs while the child is playing with the Q-tip. Some children will pick them out of the trash to play with them —  and who hasn’t laughed at someone walking around with a Q-tip sticking out of the ear” The problem is what happens next when the child falls or a sibling pushes the Q-tip in. A washcloth and finger work well to clean the visible external part of the ear canal in a child, which is all that you can safely reach.  So, perhaps best not to introduce your child to Q-tips — unless you are using the ones that are bigger than your elbow!

Dr. Seth Pransky is a Pediatric Otolaryngologist at Pediatric Specialty Partners. Previously the Director of Pediatric Otolaryngology at Rady Children’s Hospital for 20 years, he is an expert in pediatric ear disease and sinus problems, complex airway and voice abnormalities and sleep apnea in children. He trained at the Washington University School of Medicine, the University of Pennsylvania, and National Children’s Hospital in DC.  His new private practice office is in the La Jolla Medical and Surgical Center, at 8929 University Center Lane, Suite 208.
Families can call for an appointment at (858) 625-0809 or through the Pediatric Specialty Partners website: pediatricspecialtypartners.com.