A previously healthy 7-year-old male is brought to the pediatric clinic with concern for a foreign body in his ear. He had been in class, playing around by inserting a red pencil in his ear. The teacher became alarmed and told him to stop. When the pencil was removed, the tip of the pencil was missing.
The child has the tip of a red pencil in his ear.
Kids will find endless foreign bodies to insert in their ears. Tic Tacs, plastic parts, beads, more beads, and of course everyone’s favorite, popcorn. Removal techniques include forceps, glue tips, Katz extractors, and irrigation. The correct technique depends on the object and the level of cooperation of the patient. In young children, you will often have one chance to remove the object in the clinic. After one attempt, the child is often no longer cooperative. When this happens, sedation in the operating room is required. The Wispr digital otoscope is helpful in determining the position of the foreign body to help guide a removal technique, increasing the chance of first-attempt success.
In this case, the pencil tip was removed uneventfully with a lighted curette.
Here’s a video of the exam:
Complete exam video
WiscMed thanks Dr. Joao Mauricio Scarpellini for this interesting case. Dr. Scarpellini is a pediatrician in private practice in Rio de Janeiro, Brazil.