Objective: To determine if there is a relationship between a foreign body in the external auditory canal and undiagnosed otitis media with effusion or significant eustachian tube dysfunction in children.

Study design and setting: This is a prospective, uncontrolled analysis of 37 consecutive children with a foreign body in the external auditory canal (group I) and 37 children with non-ENT complaints as a control (group II), seen over two years in the ENT unit of a district general hospital. All the children underwent removal of the foreign body, examination of both ears by a senior ENT surgeon followed by tympanometry within seven to 10 days.

Result: Thirty-seven children with a foreign body in the external auditory canal (group I) were analysed and a similar number of children with non-ENT problems (group II) were taken as a control. The age range for both groups was two years to 10 years with a median age of six years. Of the 37 children, 25 (68 per cent) in group I had an abnormal view of the tympanic membrane compared to only five (14 per cent) in group II (p < 0.04 – chi-squared test). In group I 20 children (54 per cent) and in group II three children (8 per cent) had abnormal middle-ear compliance (either type B or type C2) (p < 0.05 – chi-squared test). Nineteen (51 per cent) children in group I had a history of previous ear symptoms such as irritation, otalgia, blockage or deafness more than once in the past six months, and none had in the control group (p < 0.03 – chi-squared test).

Conclusion: There is clinical and statistical evidence to suggest that children may insert a foreign body in the ear as a result of irritation/pressure sensation secondary to otitis media with effusion or significant eustachian tube dysfunction. Therefore, we recommend that all children with a history of a foreign body in the ear should be screened in an ENT clinic.