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Foreign Bodies in the Ear.
The substances which in this way find entrance in the ear present a most remarkable variety; the favorite articles are beads, peas, beans and small nuts, but the monotony is varied by using pieces of wood, slate pencils, and indeed anything which comes first to hand when the desire for exploration seizes the child.
In many cases the presence of this body in the ear is not discovered for some time ; not, indeed, until the child's deafness calls attention to the existence of something wrong in the ear. In other cases the foreign body excites an irritation, which causes the child to complain of pain, and often induces an inflammation, accompanied by a " running " from the ear. At other times this foreign body excites no immediate difficulty, becomes incrusted with wax, and remains in the ear for years.
On the other hand, parents and friends are often mistaken in supposing that some foreign substance has lodged in the ear. If the child complain of a " buzzing " in the ear, the friends are often disposed to believe that some foreign substance has found its way into the channel, and refuse to be convinced to the contrary. If this buzzing be very loud, they usually think at once of some insect as the probable cause of it. Now the fact is that a buzzing or roaring sound in the ear is a frequent symptom of many affections, some of which involve the ear only, while others have nothing to do with this organ. There are various conditions of the system in which the patient fancies he hears a roaring sound continually-a fact which should be borne in mind by those who are incapable of imagining any other cause for a buzzing in the ear than the presence of a fly.
Much injury has been done by rough and ignorant efforts to extract supposed foreign bodies from the ear when none actually existed ; for at the extremity of the bony channel there are situated some of the delicate organs which are necessary for perfect hearing, and the attempt to remove foreign bodies from the bony channel may easily injure some of these parts, and even destroy the hearing entirely.
Treatment. - If the foreign body can be distinctly seen from the outside, a gentle attempt to extract it may be made by using a pair of fine pincers (forceps). Great care should be used not to injure the skin of the part by clumsy use of the instrument.
If no foreign substance can be seen in the ear, no attempt to extract it with instruments should be made except by a surgeon.
In most cases the body can be removed by syringing the ear with warm water. In order to accomplish this, a large syringe, holding say six or eight ounces, should be filled with lukewarm water ; this is held in one hand, the nozzle of the instrument being placed against the upper part of the opening of the ear, so that the stream of water shall flow along the roof of the channel and be permitted to return along the lower part. The operation will be facilitated by raising the fleshy part of the external ear. To accomplish this, three fingers of the left hand may be steadied against the patient's head, while the upper part of the rim of the ear is grasped between the thumb and finger of the same hand. The ear is then gently raised and pulled slightly backward, whereby the channel of the ear is rendered somewhat straighter, and the escape of a foreign body is facilitated. The water should be forced into the ear with only a gentle pressure on the piston ; if too much force be used the delicate structures of the internal ear may be injured.
The syringing may be continued five or ten minutes ; if at the end of that time no foreign substance has been removed, the effort may be discontinued and repeated again several hours later. More than this it is not advisable for a non-professional hand to attempt, since the removal of foreign bodies from the ear sometimes taxes the skill of the surgeon. After syringing, the ear should be dried with a towel and a little plug of cotton placed in the opening for a few hours.
The syringe selected should work easily and accurately, so that no air bubbles need be forced into the ear; if the piston be loose, so that air enters with the water, the operation is apt to be extremely unpleasant to the patient.
The patient's clothing should be protected by towels placed on the shoulder and tucked in behind the collar ; a basin should be held close to the ear and touching the head so that the water may run back into the vessel and not escape down the patient's neck.
The basin which is used for this purpose should be a separate one from that which contains the water to be injected, so that this water may remain clean and not become soiled with the matters which are washed out of the ear.
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