Dawaa Reference

chronic

Ear foreign body (acute management & removal)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

NICE CKS Ear Foreign Body · No labelled dose - plain oil, instilled to effect

Verified against2 documents
  • No labelled dose - plain oil, instilled to effect
  • Ear Foreign Body Removal - disease-level clinical article (foreign-body-ear-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Red flags (5)

  • A button battery needs emergency removal - caustic injury and toxic chemical release
  • Refer rather than attempt if the object is ungraspable, wedged, sharp, organic, or lying against the eardrum
  • Refer if the eardrum is perforated, the canal is injured, there is excessive bleeding or pus, or a mass such as cholesteatoma is suspected
  • Do not irrigate a spongy object - it swells when wet
  • Refer after a failed attempt, or when the patient cannot cooperate or the equipment and lighting are not adequate

Symptoms — what the patient reports (1)

  • Ear pain, ear discharge, tinnitus, dizziness or hearing loss - patients do not always describe putting something in the ear [dizziness · ear discharge · ear pain · hearing loss · tinnitus]

Signs — what you find (2)

  • The foreign body is usually seen in the external auditory canal with good lighting [foreign body]
  • Delayed removal causes canal oedema and ear pain, and makes the procedure harder [ear pain · oedema]

If not this — what else fits (3)

  • Commonest in children aged 1 to 4; beads, paper or tissue, and popcorn kernels together are over half of cases
  • In adults, hearing-aid or earbud fragments, cotton buds, and insects
  • The ear canal is the commonest foreign body site overall at 44%, then nose 25% and pharynx 23%

SourceStatPearls "Ear Foreign Body Removal" (NBK459136) - the procedure chapter; it covers how it presents, when to attempt removal and when to refer

Presentation findings are traced to the source above.

1

OLIVE OIL

1st line

Formear

Adult dose and duration

Instill 3-5 drops of mineral oil or olive oil into the affected ear canal to drown live insects prior to removal - single application

Paediatric dose

Instill 2-3 drops into ear canal; safe in children provided tympanic membrane is intact

Dose source

No labelled dose - plain oil, instilled to effect

Why

Immobilizes live insects immediately to stop pain and canal trauma before mechanical removal

Cautions
  • DO NOT instill oil or aqueous solutions if organic foreign body (e.g. seed, bean, button battery) is present (seeds swell; batteries cause chemical burns).
  • CONTRAINDICATED if tympanic membrane perforation or tympanostomy tube is suspected.
  • Button batteries require IMMEDIATE emergency ENT extraction (do not attempt syringe flushing).
  • Plain olive oil carries no licensed dose. Warm it to body temperature first - cold oil in the ear canal sets off vertigo and nausea.
Egyptian brands
Egyptian brandManufacturerIndicative price
AURIS EAR DROPS 15 ML! also contains almond oil, bht, calendula oil, chlorobutanol, paraffin oil, tea tree oil, vitamin eHEALTHY GROUP FOR COSMETICS > LANDMARK PHARMA10.50 EGP
OLIVRUM 15 ML EAR DROPS! also contains almond oil, chamomile oil, climbazole, coconut oil, lavender oil, lidocaine, paraffin oil, tea tree oilNILE COSMOTICS FACRORY > NUTRISYNTH FOR TRADE AND DISTRIBUTION49.00 EGP
ALEAVIA EAR DROPS 15 ML! also contains almond oil, coconut, garlic oil, paraffin, tea tree oilEL NILE > OPTIMASA60.00 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Ear Foreign Body Removal - disease-level clinical article (foreign-body-ear-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Button batteries in the ear canal require emergent (not routine) removal because of caustic injury and toxic chemical release risk.
  • RED FLAG - Superabsorbent polymer bead foreign bodies must NOT be treated with oil or otic drops (drops can worsen swelling/injury) - dry ear precautions and urgent otolaryngology referral are needed instead. Do not instil oil unless the object is a confirmed insect rather than a swelling bead.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.