Not 'just' a foreign body in the ear canal

Abstract

Foreign bodies are commonly seen by the Ear, Nose and Throat emergency team with cotton wool being the most common aural foreign body seen in the adult population. Most complications secondary to aural foreign bodies described in the literature are minor and rarely require any surgical intervention. Here, we present two cases with impacted cotton wool as aural foreign bodies which resulted in suppurative labyrinthitis and osteomyelitis causing profound sensorineural hearing. These cases highlight the importance of considering aural foreign bodies in the differential diagnosis in those presenting with unilateral symptoms as significant complications, although rare, can occur, particularly in those with delayed diagnosis.

Keywords: ear, nose and throat/otolaryngology; emergency medicine; general practice/family medicine; otolaryngology / ENT.

Figure 1

Coronal view CT temporal bones of case 1; green arrow showing left-sided lateral semicircular canal dehiscence.

Figure 2

Axial view CT temporal bones of case 1; green arrow showing left-sided bony loss of the carotid canal margin.

Figure 3

Pure tone audiogram of case 1 showing profound left-sided sensorineural hearing loss.

Figure 4

Axial view of CT temporal bones of case 2; green arrow showing erosion of left temporomandibular joint.

Figure 5

Coronal view of CT temporal bones of case 2; green arrow showing erosion of the left basal turn of cochlea.

Figure 6

Pure tone audiogram of case 2 showing profound left-sided sensorineural hearing loss.