A child has a small, round object in the external auditory canal near the tympanic membrane; the parent suspects a dried pea. What should the nurse practitioner do to remove this object?

A child has a small, round object in the external auditory canal near the tympanic membrane; the parent suspects a dried pea. What should the nurse practitioner do to remove this object?

• A. Irrigate the external auditory canal to flush out the object
• B. Refer the child to an otolaryngologist for removal
• C. Remove the object with a wire loop curette
• D. Use a bayonet forceps to grasp and remove the object

Answer: (B)

When a foreign object is in the external auditory canal and sits close to the tympanic membrane, especially if it’s organic like a dried pea, the safest approach is removal by a specialist. Irrigation is discouraged in this situation because moisture can cause the object to swell, expand, or move toward the tympanic membrane, increasing the risk of pushing it deeper or perforating the eardrum. Attempting removal with instruments such as a wire loop curette or bayonet forceps in a small canal near the membrane also carries a real danger of injuring the delicate structures of the middle ear or perforating the tympanic membrane, particularly in a young child. A trained otolaryngologist has the appropriate magnification, gentle technique, and specialized tools to visualize and extract the object safely, sometimes under anesthesia if needed. This minimizes trauma and reduces the chance of complications. If the object is near the tympanic membrane and is organic in nature, deferring to ENT for removal is the prudent choice.

When a foreign object is in the external auditory canal and sits close to the tympanic membrane, especially if it’s organic like a dried pea, the safest approach is removal by a specialist. Irrigation is discouraged in this situation because moisture can cause the object to swell, expand, or move toward the tympanic membrane, increasing the risk of pushing it deeper or perforating the eardrum. Attempting removal with instruments such as a wire loop curette or bayonet forceps in a small canal near the membrane also carries a real danger of injuring the delicate structures of the middle ear or perforating the tympanic membrane, particularly in a young child.

A trained otolaryngologist has the appropriate magnification, gentle technique, and specialized tools to visualize and extract the object safely, sometimes under anesthesia if needed. This minimizes trauma and reduces the chance of complications. If the object is near the tympanic membrane and is organic in nature, deferring to ENT for removal is the prudent choice.