Straighten the ear canal and visualize the foreign body directly with a speculum, ensuring the tympanic membrane is intact ( Fig 130.13C ) If the foreign body is spongy or could expand when wet, such as a bean or other food material, not use this method Do not attempt to remove a button battery with irrigation Remove the speculum and irrigate the ear canal by injecting a constant stream of water at body temperature Use a 20- to 50-mL syringe attached to flexible tubing (e.g., a cut section of tubing from a butterfly needle) Repeated irrigation may be necessary to provide complete emptying Day Ear Hook Visualize the foreign body with a speculum, preferably using an operating head otoscope or metal ear speculum Then, slowly advance the Day ear hook just beyond the foreign body Once beyond the foreign body, rotate the head of the hook 90 degrees to snag the foreign body Slowly withdraw the ear hook until the foreign body is removed Space to pass the tip of the ear hook beyond the foreign body is a prerequisite for success with this method This method should not be employed if the foreign body is immediately adjacent to the tympanic membrane Katz Extractor Visualize the foreign body with a speculum, preferably using an operating head otoscope or metal ear speculum Then, slowly advance the deflated balloon of the Katz extractor just beyond the foreign body as shown Once the deflated balloon is beyond the foreign body, depress the plunger on the syringe to inflate the balloon and slowly withdraw the extractor with the balloon inflated from the ear The foreign body will be forced out of the external auditory canal by the inflated balloon Space to pass the balloon beyond the foreign body is a prerequisite for success with this method This method should not be employed if the foreign body is immediately adjacent to the tympanic membrane ASPIRATION OF AN AURICULAR HEMATOMA Indications Traumatic auricular hematoma or seroma Complications Recurrent hematoma or seroma Infection (abscess) Procedure