Piromchai Patorn, Srirompotong Somchai, Lertchanaruengrith Piyawadee, Mills Robert
Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Clin Med Insights Case Rep. 2012;5:1-4. doi: 10.4137/CCRep.S8214. Epub 2012 Jan 5.
Foreign bodies in the external auditory canal are common in both adults and children. Removal of the foreign body requires skill, but is usually successfully performed in the emergency department. We report a case of a child with a bullet in ear canal which was pushed into the middle ear during an attempt to remove it.
A 6-year-old Thai boy went to the community hospital with his parents, who reported that their child had pushed a bullet into his ear. Otoscopic examination revealed a metallic foreign body in his external auditory canal. The first attempt to remove the foreign body failed and the child was referred to an otolaryngologist. We found that the tympanic membrane was ruptured, with granulation tissue in the middle ear and the bullet was located in the hypotympanum. The foreign body was removed via a post-auricular approach.
Removal of a foreign body from external auditory canal is an essential skill for physicians. Careful removal can prevent further trauma and complications. When the first attempt fails, referral to an otolaryngologist is recommended.
外耳道异物在成人和儿童中都很常见。取出异物需要技巧，但通常在急诊科能成功完成。我们报告一例儿童耳道内有子弹，在试图取出时被推入中耳的病例。
一名6岁泰国男孩随父母前往社区医院，其父母称孩子将一颗子弹塞入耳朵。耳镜检查发现其外耳道内有一金属异物。首次取出异物的尝试失败，该患儿被转诊至耳鼻喉科医生处。我们发现鼓膜破裂，中耳有肉芽组织，子弹位于鼓室下隐窝。通过耳后入路取出了异物。
从外耳道取出异物是医生的一项基本技能。谨慎取出可防止进一步创伤和并发症。首次尝试失败时，建议转诊至耳鼻喉科医生处。
