Ear, Nose, And Throat Disorders Chapter 83. It may be removed by irrigation, but rolling the cerumen out of the ear canal with a blunt curet or loop or removing it with a vacuum through a tube is quicker, less messy, generally safer, and more comfortable for the patient. Irrigation is contraindicated if the patient has a history of otorrhea or perforation of the tympanic membrane. Water entering the middle ear through a perforation may exacerbate chronic otitis media. Cerumen solvents are not recommended because they often do not dissolve the mass and frequently cause maceration of the canal skin and allergic reactions.
Children insert all types of objects, particularly beads, erasers, and beans, into their ear canals.
A foreign body in the ear canal is best removed by raking it out with a blunt hook. Forceps tend to push smooth objects deeper into the canal. A foreign body lying medial to the isthmus is difficult to remove without injuring the tympanic membrane and ossicular chain. A general anesthetic should be used when a child is uncooperative or when a mechanical problem could make removal difficult, possibly injuring the tympanic membrane or ossicles. Insects in the canal are most annoying while alive.