Relative contraindications (otolaryngologist should be consulted) External auricular canal infection or swelling around the object Impacted object Complications of Removing an Ear Foreign Body Perforation of the tympanic membrane Infection from retained organic matter or irrigant Injury (eg, laceration, bleeding, edema) of the external canal Rarely, damage to the middle and inner ear Equipment for Ear Foreign Body Removal Handheld otoscope Otoscopy speculum: Use the largest speculum that fits into the external canal For irrigation: 30 - to 60-mL syringe filled with sterile water warmed to body temperature and attached to a 16 - to 19-gauge catheter or tubing (such as a butterfly cannula with the needle cut off) Ear suction catheter (#5 or #7 Baron suction with thumb control hole) Alligator forceps Right-angle hook or cerumen loop / curette For insect removal: Lidocaine solution or warm mineral oil A headlamp and magnifying loupes if available Additional Considerations for Ear Foreign Body Removal Document any preexisting injury to the external canal or possible perforation of the tympanic membrane before the procedure so that this cannot be attributed to the procedure.