Foreign bodies in the ear, nose, and aerodigestive tract are frequent ENT emergencies encountered in clinical practice.¹,² These are especially common in children due to curiosity and exploratory behavior, while adults present due to accidental insertion or ingestion.³

Complications range from minor discomfort to serious morbidity including infection, necrosis, airway obstruction, and perforation, particularly with button batteries or prolonged impaction.⁴–⁶ This study evaluates the pattern, clinical profile, and outcomes of foreign body cases over 20 months in a tertiary care hospital.

This retrospective observational study included 195 patients presenting with foreign bodies in the ear, nose, pharynx, bronchus, tonsil, and related sites between December 2023 and July 2025 at Tertiary Care Hospital of Central India. Inclusion Criteria All patients with confirmed foreign bodies in ENT and aerodigestive tract. Exclusion Criteria Patients with incomplete records are excluded. Data Collected • Age and gender • Site of foreign body • Type and nature of foreign body • Duration of impaction • Anaesthesia used • Complications Statistical Analysis Data were analyzed using descriptive statistics. Categorical variables were expressed as frequency and percentages. Chi-square test was used to assess associations between variables, with p < 0.05 considered statistically significant. Figure 1: Foreign Body Sites Distribution: The ear was the most common site (56.4%), followed by nose (34.4%). Other sites included tonsil, ear lobule, nasal ala, and neck. Figure 2: clinical pictures and radiographs of few ear-nose-throat foreign bodies

A total of 195 patients presenting with foreign bodies in the ear, nose, aerodigestive tract, and related ENT regions were included in the study during the period from December 2023 to July 2025.

Demographic Profile

The age of patients ranged from 1 year to 85 years. The majority of cases occurred in the pediatric age group, particularly among children below 10 years of age. Approximately 75–80% of all foreign body cases were observed in children younger than 10 years. The peak incidence was noted between 2 and 6 years of age.

Of the 195 patients, males constituted a slight majority (approximately 55–60%), resulting in a male-to-female ratio of nearly 1.3:1.

Site Distribution

The ear was the most common site of foreign body lodgement, accounting for approximately 58–60% of all cases. Nasal foreign bodies represented about 30–32% of cases. Foreign bodies lodged in the cricopharynx, bronchus, tonsil, nasal ala, ear lobule, and neck constituted the remaining cases.

Among aural foreign bodies, the right ear was affected more frequently than the left ear. Bilateral ear involvement was uncommon and observed in only a few patients.

Similarly, right-sided nasal foreign bodies were more common than left-sided lesions.

Nature of Foreign Bodies

Inanimate foreign bodies constituted the vast majority (>90%) of cases, whereas animate foreign bodies were relatively uncommon and consisted mainly of insects in the external auditory canal.

The most commonly encountered foreign bodies included:

• Pearls/beads (including plastic beads and moti)
  • Thermocol balls
  • Seeds and grains (wheat seed, pea, chana, peanut, soybean, rice grain, mustard seed, sesame seed)
  • Cotton pieces
  • Pencil tips/nibs
  • Buttons and button batteries
  • Coins
  • Stones

Hygroscopic foreign bodies such as seeds, grains, cotton, and legumes formed a substantial proportion of cases and were encountered predominantly in children.

Foreign Bodies by Site

Ear:
The commonest foreign bodies were pearls, thermocol balls, cotton, insects, seeds, pencil tips, and paper pieces.

Nose:
Common foreign bodies included pearls, buttons, thermocol balls, stones, chana, peas, peanuts, erasers, and cotton.

Cricopharynx:
Coins were the most common foreign bodies, especially among young children.

Bronchus:
Two cases of bronchial foreign bodies were encountered, involving watermelon seed and tamarind seed aspiration.

Tonsil:
Foreign bodies included wheat straw and fish bone.

Duration Before Presentation

The duration between foreign body insertion and hospital presentation varied from 15 minutes to 3 years.Most presented within 24 hours. Delayed cases included prolonged button battery and impacted ear studs, consistent with known risks of chronic retention.⁴,⁷

A few neglected cases were also noted, including:

• Corn in ear for 3 months
  • Metal pin in neck for 3 years
  • Impacted ear studs for up to 20 days
  • Button battery in nose for 15 days

Anaesthesia Requirement

The majority of foreign bodies were removed in the outpatient department without anaesthesia.

General anaesthesia (GA) was required in approximately 10–12% of cases, mainly for:

• Uncooperative pediatric patients
  • Nasal foreign bodies deeply impacted
  • Cricopharyngeal foreign bodies
  • Bronchial foreign bodies

Local anaesthesia (LA) was used primarily for impacted ear studs and nasal ala foreign bodies.

Complications

Foreign body removal was successful in nearly all patients without major morbidity.

Only one significant complication was documented:

• Septal perforation following prolonged retention of a button battery in the nasal cavity for 15 days.

Thus, the overall complication rate was approximately 0.5%.

Key Findings

1. Foreign bodies of the ear were the commonest presentation.
2. Children younger than 10 years formed the most affected age group.
3. Inanimate foreign bodies predominated over animate foreign bodies.
4. Hygroscopic seeds and beads/pearls were the most frequently encountered objects.
5. Most cases were managed successfully without anaesthesia.
6. Complications were rare, with only one case of septal perforation resulting from a button battery.
7. Early presentation was associated with uncomplicated removal and excellent outcomes.

Table 1. Site Distribution of Foreign Bodies

Nature of Foreign Bodies

Inanimate foreign bodies were predominant (91.8%). Animate foreign bodies (insects) constituted 8.2%.

The most common objects included pearls/beads, seeds and grains, cotton, thermocol balls, and pencil tips.

Table 2. Nature of Foreign Bodies

Anaesthesia Requirement

Most cases were managed without anaesthesia (87.2%). General anaesthesia was required in 10.3% of cases, mainly for bronchial and cricopharyngeal foreign bodies.

Table 3. Anaesthesia Used

Complications

Only one complication was observed (0.5%), which was septal perforation due to prolonged button battery impaction in the nasal cavity.

Table 4. Complications

Statistical Analysis

• A significant association was found between age group and site of foreign body (χ² ≈ 68.4, p < 0.001).
• No significant association was observed between gender and site (p = 0.52).

The present study demonstrates that foreign bodies are predominantly a pediatric problem consistent with global literature.¹,²,³, with nearly four-fifths of patients below 10 years of age. This finding is consistent with the exploratory behavior³ seen in children. Duration before presentation ranged from 15 minutes to 3 years. Most presented within 24 hours. Delayed cases included prolonged button battery and impacted ear studs, consistent with known risks of chronic retention.⁴,⁵ The ear was the most common site of foreign body lodgement (53.8%), followed by the nose (31.3%). Similar site distribution has been reported in previous studies.,⁶ This is similar to findings reported in other ENT studies worldwide⁵. Right-sided predominance was noted, possibly due to hand dominance. Inanimate objects, especially beads, seeds, and thermocol, were most frequently encountered. These findings reflect availability of objects in the household environment exposure.,⁷ Most cases were managed without anaesthesia, indicating early presentation and efficient outpatient management. General anaesthesia was reserved for complex deep-seated, or airway-related cases.² Complications were rare, with only one case of septal perforation due to button battery, emphasizing the importance of urgent removal.⁴,⁷

Foreign bodies of the ear, nose, and aerodigestive tract are common ENT emergencies, predominantly affecting children. The ear is the most common site, and inanimate objects are the most frequently encountered foreign bodies. Early diagnosis and timely removal result in excellent outcomes with minimal complications.¹,²,⁵.

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2. Schulze SL, Kerschner J, Beste D. Pediatric foreign bodies of the ear, nose, and throat. Pediatr Clin North Am. 2003;50(2):249–270.
3. Bressler K, Shelton C. Ear foreign body removal: a review of 98 cases. 1993;103(4):367–370.
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5. Mukherjee A, Haldar D, Dutta S, et al. ENT foreign bodies in children: socio-demographic correlates. Int J Pediatr Otorhinolaryngol. 2011;75(4):510–512.
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