2 English reference foreign bodies in the ear [Chinese medicine terminology examination and approval Committee. Terminology of Traditional Chinese Medicine (2004)]
3. Summarize the foreign body in ear (1) as the name of the disease. Also known as foreign body in external auditory canal. According to the different objects, the documents of past dynasties have different names, such as things in the ear, insects in the ear, moths in the ear, dragonflies in the ear and so on. Refers to diseases caused by foreign bodies entering the ear by mistake [1].
4 diagnosis of foreign body entering the ear l, according to the medical history and local examination, the foreign body in the external auditory canal can be clearly diagnosed.
2, according to the shape, nature, size and location of foreign bodies, there are different symptoms. There may be pain, blockage and discomfort in the ear, and there may be no obvious symptoms in the light.
3. Pay attention to distinguish it from non-foreign bodies such as cerumen, pus scab and blood scab.
5 Causes and pathogenesis of foreign bodies entering the ear Common foreign bodies are:
(1) Animal foreign bodies such as mosquitoes, flies, ants and leeches. Occasionally fly into or climb into the ear canal, causing symptoms [2].
(2) Plant foreign bodies such as beans, stones, rice and abiotic foreign bodies such as gravel, broken glass, broken cotton swabs, etc. Most of them are because children are not sensible, put foreign objects in their ears during play or other accidents, and let foreign objects enter [2]. Or accidentally enter the ear hole due to ear digging, treatment, trauma, etc.
If it is a water-absorbing foreign body (beans, paper balls, etc. ), the volume will expand due to water absorption, or foreign bodies will damage the skin of the ear canal, and evil toxins will invade the outside, causing skin swelling, pain and erosion [2].
Due to the blockage of foreign bodies, the ears are blocked, and it is unfavorable to clear the body, so it can cause hearing loss, tinnitus, or reflex cough; Foreign body compresses the ear hole, the vein is blocked, and it hurts when it doesn't work, so the ear hurts; Vein injury, internal and external pathogens steaming the ear orifice, will cause swelling and erosion of the external auditory canal; Insects crawl in the ear, disturbing the orifices and making people uneasy, so patients are afraid of impatience and itching.
6 The symptoms of foreign body entering the ear vary according to the shape, nature, size and location of the foreign body [2]:
Small body, no swelling, no foreign body, no obvious symptoms in the ear;
Large foreign bodies blocked in the ear canal can cause tinnitus, hearing impairment and reflex cough.
Water-absorbent foreign bodies swell in contact with water and oppress the ear canal, which can often cause swelling and erosion of the ear canal;
Animal foreign bodies, due to crawling and commotion in the ear, make patients fidget, cause unbearable itching or tinnitus, and even bleed or damage the eardrum, resulting in perforation of the eardrum;
The foreign body is embedded in the isthmus of the ear canal, and the pain is more severe;
Foreign bodies near the eardrum will compress the eardrum, causing tinnitus and dizziness.
7 Diagnosis of foreign bodies entering the ear According to the medical history and local examination, foreign bodies in the ear canal can be definitely diagnosed [2].
8 Diseases that need to be differentiated from foreign bodies in the ear should be differentiated from cerumen [2].
9 Treatment of foreign bodies entering the ear The principle of treating foreign bodies in the external auditory canal is to take them out through various methods. Anyone who finds a foreign body in the ear should go to the hospital for treatment as soon as possible, and don't dig blindly, so as not to push the foreign body deep or cause damage.
9. 1 For external treatment of plant and abiotic foreign bodies, take them out with ear hooks or ear forceps. The ear hook should enter along the gap between the ear canal and the foreign body or the front and lower part of the ear canal to hook out the foreign body. During the operation, it is necessary to explore them gently and quietly to avoid damaging the ear canal or eardrum. It is not advisable to rinse with water to avoid swelling and difficulty in taking it out. [2]
Spherical foreign bodies, such as glass balls and glass beads, can be hooked out with a curette, and must not be clamped with tweezers or pliers to prevent foreign bodies from sliding into the deep part of the ear canal and damaging the eardrum [2].
Light and thin foreign bodies can be coated with vaseline or sticky substances on the cotton swab head and stuck out [2].
Small movable foreign objects can be washed out by washing. When washing, do not directly wash the foreign body, so as not to lead to deeper foreign body, foreign body that swells in water or is prone to chemical change, external auditory canal and tympanic membrane injury or perforation, and the washing method is prohibited. [2]
Animal foreign bodies are dripped into the ears with vegetable oil, wine, ginger juice or ether and dicaine, and then taken out with tweezers after the insects die, or taken out with water washing [2].
For swollen foreign bodies, stir them into small pieces and take them out in pieces, or take them out after dropping 95% alcohol for dehydration and contraction [2].
For restless and uncooperative children, foreign bodies can be removed under general anesthesia [2].
Precautions:
① In case of acute inflammation, foreign bodies can be removed after anti-inflammatory treatment. If the foreign body affects the regression of inflammation, it can be taken out as appropriate during the anti-inflammatory process.
② When taking foreign bodies, the operation must be dexterous and skilled, and it is forbidden to take them out blindly and forcibly, so as not to damage the skin and tympanic membrane of the external auditory canal. Especially for beans, glass beads and other round smooth foreign bodies, it is forbidden to take them with tweezers and pliers at will to avoid pushing them deeper.
③ Whether the foreign body is embedded in the external auditory canal and difficult to take out, whether the wound enters the shrapnel, etc. A mastoid incision can be made behind the ear to separate the cartilage of the external auditory canal and then remove the foreign body.
(4) Children who do not cooperate or the foreign body is too tight to be removed can be removed after a short period of general anesthesia.
9.2 During internal treatment, redness, swelling, pain and erosion occurred during the removal of foreign bodies, or the skin of the ear canal was damaged by water-absorbing foreign bodies due to expansion.
9.2. 1 Therapy for clearing away heat and toxic materials, reducing swelling and relieving pain.
9.2.2 Wuwei Disinfection Drink [Remarks] Wuwei Disinfection Drink (Medicine Zong Jin Jian) can be taken orally: honeysuckle, wild chrysanthemum, dandelion, viola yedoensis, and semiaquilegia seeds can clear away heat, detoxify and reduce swelling, and take out foreign bodies after local swelling subsides [2].
Modified prescriptions: Flos Lonicerae 15g, Flos Chrysanthemi Indici 15g, Herba Taraxaci 15g, Radix Paeoniae Rubra 15g, Radix Scutellariae 12g, Radix Bupleuri 12g, and Radix Glycyrrhizae 6g. Decoct with water. If it is swollen, add 10g windproof. In case of excessive heat, Radix Gentianae 12g and Herba Violae 12g are added.
Chinese patent medicine:
(1) chuanxinlian tablets, taken orally, 4 tablets each time, 3 times a day.
(2) Niuhuang Jiedu tablets, taken orally, 4 tablets each time, 3 times a day.
10 nursing care of patients with foreign bodies in the ear After the foreign bodies are taken out, the ear canal should be kept dry and clean [2].
1 1 prevent foreign objects from entering the ear: to quit the habit of digging ears, educate children not to put small objects in their ears [2].