Examine the ear canal with an Otoscope while drawing up and back on the pinna to assist straighten the ear canal and improve visibility. Start by putting a substance to destroy the bug in the ear canal if there is a live one there. Workable options include mineral oil, 2% lidocaine (Xylocaine), and benzocaine/antipyrine (Auralgan). If there is a myringotomy tube in place or any other opening of the Tympanic Membrane [TM], sterile 2% lidocaine would be the best choice. Before dripping the liquid into the canal and pulling on the pinna and pushing on the tragus to remove air bubbles, tell the patient to lie on his or her side.
Water irrigation is a very efficient removal method when a foreign body (FB) is not too securely lodged in the canal and if there is no myringotomy tube or tympanic membrane rupture. A syringe and a scalp vein needle that has been sharpened can be used for this. The foreign body can be removed using body-temperature tap water. To flush out the object, direct the stream along the canal's wall and around it.
