MDT EAR Foreign Body/ cerumen impaction

Question 1

What are the instruments of choice for removal of a foreign body in the ear

Answer 1

Cerumen loops/scoops,
right angle hook,
alligator forceps

Question 2

IF there is a live object in the ear canal what do you do?

Answer 2

Live objects should be drowned with a 2% lidocaine solution or viscous lidocaine

Question 3

Why are live objects drowned in 2% lidocaine or viscous lidocaine?

Answer 3

this immediately paralyzes the offending insects and provides modest topical anesthesia.

Question 4

True/False
Irrigation should not be used unless the TM is completely visualized.

Answer 4

True

Question 5

True/False
Complete a thorough inspection of ear canal is not needed after the foreign body is removed

Answer 5

False
Complete a thorough inspection of ear canal TO insure foreign body is completely removed

Question 6

What is considered for more serious cutaneous damage or if foreign body consist of an organic material?

Answer 6

Topical antibiotics

Question 7

What are some complications for foreign body?

Answer 7

(1) Perforated TM
(2) Hearing Loss
(3) Cellulitis

Question 8

Although some patients with cerumen impaction may present with a c/c totally unrelated to the ears, the majority of patients will report decrease in what and/or what?

Answer 8

hearing, and/or a
sensation of pressure or fullness

Question 9

True/False
Symptoms of a Cerumen Impaction are often precipitated by the use of cotton-tipped applicators

Answer 9

True

Question 10

True/False
Most of the time, cerumen impaction can be removed using cerumen loops/scoops.

Answer 10

True

Question 11

1. If irrigation is the treatment choice, it can usually be accomplished with an ear syringe, a flexible _________ guage IV catheter, or a syringe attached to the tubing of a butterfly infusion catheter.
2. Use body temperature water to minimize the development of _____.
3. Insert the catheter into the _____ canal (external third) and gently irrigate along the superior portion of the external auditory canal utilizing the pressure from the stream to help breakup and dislodge impaction.

Answer 11

1. 18 Gage
2. Vertigo
3. Cartilaginous

Question 12

If irrigation fails, then the next step would be to use WHAT?

Answer 12

Carbamide Peroxide (Debrox) – cerumenolytic
Instill 2-5 drops in affected ear BID for a max of 4 days.

Question 13

What is the most common injury associated with syringing of the ear?

Answer 13

traumatic TM perforation

Question 14

True/False
Carbamide Peroxide (Debrox) is indicated for perforated TM

Answer 14

FALSE
Contraindicated