Foreign bodies in the ear: a simple technique for removal analysed in vitro - oral water jet

Abstract: Objective: foreign bodies in the ear mainly occur in children.
This can often cause problems, especially in cases of accidents and emergencies where microscope or expert help is often not available.
This paper presents a simple, safe and effective method of ear ringing.
The simplicity and simplicity of the process and equipment are described.
Methods and Results: The device consists of a "one-time" sterile kit consisting of a 20 ml syringe, body temperature saline and a 14 or 16-gauge sleeve (needle-free.
An in vitro experiment was carried out to calculate the pressure generated by the water jet on the drum membrane.
The pressure is much lower than the pressure required for the rupture of the drum membrane, so it is safe to use this technology.
Conclusion: earbuds are an effective and easy way to remove most foreign bodies.
There must be a detailed medical history and ear mirror examination before surgery.
The new Syring method with the usual safeguards described in this paper may be a useful auxiliary means to manage this common situation.
Foreign objects in the ears are mainly encountered in children who can push jewelry, food or any small item that enters the ears into the ears.
Such children need careful management so that they will not be frightened or hurt.
Most children can believe to clean their ears with Syring.
The traditional method of earbuds is to use a metal syringe and an electric pulse water syringe.
Both methods have shortcomings, such as availability of syringes and the risk of ear damage during manual massage.
2 The metal syringe is filled with water from the receiver and the water flow is manually directed into the ear canal.
The electric syringe has an internal pump that squirts the pulse water from the connecting reservoir into the ear canal through the nozzle.
Here we describe the simple components of a security system.
The advantages of this equipment include the availability of easy assembly and disinfection equipment and the safe operability.
The new Syring queequipequip disposable kit includes a 20 ml Luer lock syringe and a 14/16 specification sleeve (without a needle) fixed on its tip (Box 1 ).
The patient was informed of the process and protected by a waterproof cloak on the shoulder.
The tip of the sleeve is introduced into the ear canal at an angle of 45 °, and in the rear upper direction away from the eardrum, the salt water flow is directed to the top of the tube.
Place a container under the affected ears.
Box 1: ear syringing kit20 disposable syringe14 or monthly meter cannalueceptacle × monthly waterproof cloak or incontinence "sheetNormal analysisOur salt water is of great concern in the influence of body temperature, this novel technique is to drum the broken ears at pressure.
Measuring the pressure of the brine jet onto the drum membrane and determining its safety, an experiment was conducted based on simple physical principles to determine the maximum pressure applied by the brine jet to the diaphragm.
P = f/a where p = pressure, f = force, a = area.
Therefore, the pressure in the syringe is equal to the ratio of force to area.
20 ml the thumb pressure on the syringe can produce a force of 25 Newton (N.
20 ml the area of the piston in the syringe is 2.
5 × 10-4 m2, so the pressure of 100 kPa (1 atmospheric pressure or 750mm Hg) can be generated.
3A diaphragm made of Biogel Surgical Gloves (Figure 1), the "In vitro drum membrane", attached to the barrel of a 3 ml syringe that has taken out the piston.
(We used a 3 ml syringe because its inner diameter corresponds to the diameter of the drum film.
) This is connected to a saline-filled pressure sensor Group (Edward life-saving type), which is further connected to the Ohmeda module cardiovascular monitoring anesthesia system.
The whole system is zeroed to the desktop and a 3 ml Luer lock syringe is attached.
A salt water is transported from a distance of 2 m to the diaphragm with a diameter of 10 ml. 5 cm.
The maximum pressure generated after six runs using each sleeve is as follows: Download figureOpen in the new tabDownload powerpoint figure 1
Up to test the pressure generated in the new ear Syring technology.
14 instrument sleeves-8 kPa (60mm Hg) 16 instrument sleeves-6.
6 baipa (50mm Hg) 18 specification sleeve-4 baipa (30mm Hg) the application of this technology we have successfully used this method, remove foreign objects from 23 children presented to our accident and emergency (A & E) department.
Patients who refused to undergo surgery and those who had foreign bodies affected or wicking (e. g. , beans) were referred to ENT.
Notes and taboos are always a good idea to let the child or parent/guardian know that they will be referred to an expert if no foreign body is removed in a & E.
Syringing should be avoided in the following cases: obvious signs of infection and external ear inflammation, which may be exacerbated by previous/present drum perforation or previous eardrum perforation or eardrum perforation.
The removal of foreign matter by Tinnitus ringing is a well described technique.
The rupture of the drum membrane is a rare but unpleasant event.
It has been described to remove foreign bodies in the ear using a pulse electric syringe, 4 but not always available in the ENT or a & E Group --up.
An oral jet washer with a special "ear rinse tip" attachment is also used to provide better pressure control and to guide the water spray more precisely.
5 The pressure applied by the metal syringe on the eardrum can be much greater than 100 kPa.
6 although the median pressure of normal membrane rupture is 121. 6 hundred PA (range 50. 6–202.
6), the median rupture pressure in the shrinking film is 60.
Eight hundred Pats have been reported.
Black and others said in their claims report that metal syringes do not penetrate healthy eardrums if used properly.
Bapat et al provided further evidence of complications arising from technical defects.
They describe a case of hearing tube damage caused by the nozzle being inserted too far into the external ear canal.
The oral jet washer can produce enough force to break the drum film even under the secondary maximum power setting.
In addition to the rupture of the drum membrane, the oral jet wash is reported to have resulted in a disruption of the ossicular bone, a round and oval window fistula, and a semi-fixation of the st bone pedal.
10 parameters for safe use of these irrigation equipment need to be better determined.
Table 1 gives a comparison of the standard system with our method.
View this table: look at the method of inline View pop-up table 1 sysyring: Advantages and disadvantages there is no evidence that metal syringes are better or worse than electric Ear Syringes, both of which are safe to use.
In a randomized trial, the effectiveness of eardrum massage using electric and metal syringes in general practice was studied and no harmful effects were found.
The literature suggests that syringing may lead to infection and that the ears should be dry after syringing removes the residual water.
The manufacturer of Propulse also suggested that at the end of the day, any residual water should be discarded, as bacteria, including P-up—
Common causes of patients who need to treat external ear inflammation.
Conclusion: removing foreign bodies by tinnitus is far from a new technique.
We propose a new Syring method, including in vitro analysis of its safety.
We would like to draw attention to the ease of assembly, operability and availability of disinfection equipment for this method.
The pressure generated by the 20 ml syringe connected to the 14 th casing is far less than the minimum pressure required for perforated eardrums, however, it turns out that it is enough to remove most of the foreign objects seen by our A & E department.
For non-cooperative patients and those with affected or wicking foreign bodies, a timely referral to an expert must be considered.
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