Otomicroscopy for Ear Foreign Body Removal

Visualization Equipment Options

• The American Academy of Otolaryngology-Head and Neck Surgery identifies three appropriate instruments for visualization during manual removal of ear foreign bodies, including handheld speculum or standard otoscope, headlamp or head mirror, and binocular microscope (otomicroscope), which offers the distinct advantage of stereoscopic magnification 1

Instruments Used with the Otomicroscope

• The American Academy of Otolaryngology-Head and Neck Surgery recommends using alligator or cup forceps, metal or plastic curette loop or spoon, right-angled hook, angulated suction tips, Jobson-Horne probe, and straight applicator with cotton wool when performing manual removal under otomicroscopic visualization 1, 2

Clinical Pearls

• The otomicroscope is most useful for assessing tympanic membrane abnormalities and providing direct visualization throughout the removal process to assess when removal is complete 1, 3
• The American Academy of Otolaryngology-Head and Neck Surgery suggests that otomicroscopy allows atraumatic cleaning with aural suctioning under microscopic guidance for high-risk patients 4

Important Caveats

• The American Academy of Otolaryngology-Head and Neck Surgery advises that instrumented removal should not be attempted if there is a tympanic membrane perforation or non-intact eardrum, history of ear surgery, or inability to visualize the tympanic membrane to confirm it is intact 1, 2, 5