Practice ABC of Ear, Nose and Throat, 6th Edition

Foreign Bodies

BMJ 2014; 348 doi: (Published 30 January 2014) Cite this as: BMJ 2014;348:bmj.g391
  1. Ricardo Persaud1,
  2. Antony Narula1,
  3. Patrick J. Bradley2
  1. 1St Mary's Hospital, London, UK
  2. 2Queen's Medical Centre Campus Nottingham University Hospitals Nottingham, UK

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  • The presence of a foreign body is a common occurrence in ENT practice

  • Foreign bodies may be organic or inorganic. The former tend to be hydrophilic and therefore will expand over time and should be dealt with promptly

  • Sharp objects also require urgent removal, especially if present in the aero-digestive tract

  • Miniature batteries wherever lodged or placed—ear, nose or throat MUST be removed immediately, otherwise corrosive injury will follow and this may result in serious complications

  • Food bolus without bone may be treated conservatively for 24–48 h with a muscle relaxant, prokinetic agent and analgesia

  • Sharp foreign bodies in the throat, tend to lodge in the tonsils, posterior tongue base, valleculae or piriform fossae and may require a general anaesthetic for removal

  • Uncooperative children usually require a general anaesthesia for removal of a foreign body within the ear, nose or throat

  • Chest X-ray can be normal with an aerodigestive foreign body, so if in doubt it is safer to perform direct endoscopic examination


The presence of a foreign body in the ear, nose or aerodigestive tract is a common occurrence in ENT practice. It can be a serious and challenging condition associated with considerable morbidity and mortality. Reports from The National Safety Council of America show that foreign bodies in the aerodigestive tract are the most common cause of accidental death in children under 6 years old.

Aural Foreign Bodies

Aural foreign bodies may present as incidental findings on otoscopy, or with otalgia, otorrhoea and hearing loss. They are most frequent in children under …

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