Expansile Superabsorbent Polymer Ball Foreign Body in the Ear

Background: Superabsorbent polymers (SAPs) are materials that can absorb large quantities of water. Small spherical SAPs are commonly marketed as toys for children. Case Report: We report the case of a 4-year-old female who presented to a pediatric emergency department with a small, marble-sized SAP that was placed in her ear by herself during the course of play at daycare. On examination, the object was translucent and difficult to visualize. After multiple attempts at removal, the object was partially removed using an ear curette. The patient sustained a small tympanic membrane perforation. During a follow-up operative intervention by otorhinolaryngology, the remainder of the object was removed using a suction device and the tympanic membrane was repaired. Why Should an Emergency Physician be Aware of This?: While large SAPs associated with intestinal obstruction have been removed from the market, smaller SAPs can present a health risk when placed in orifices such as the ear or nose. Cases of foreign body SAPs have been misdiagnosed as ear infections and treated with topical antibiotics, which can lead to enlargement of the foreign body. Irrigation techniques and topical medications should not be used. SAPs are friable and can break into multiple pieces during removal attempts. Blunt tools, such as ear curettes, may be best suited for their removal. If the item breaks up during removal or if removal fails, urgent consultation with an otorhinolaryngologist is recommended.