A living foreign body in the external auditory canal of a 65-year-old patient at the Buea Regional Hospital, Cameroon: A case report

Introduction: Foreign bodies (FBs) in the ear, nose, and throat (ENT) are frequently encountered in emergency departments (EDs), particularly in pediatric populations. In adults, common aural FBs include cerumen impactions, cotton swab remnants, and, less frequently, live insects. Case: We present a case of a 65-year-old female who was rushed to the ED of Buea Regional Hospital with acute-onset left otalgia with intermittent paroxysms every 20-30 seconds, anxiety, and abnormal behavior. Otoscopic examination revealed a live insect within the left external auditory canal (EAC), later identified as a cockroach. Immediate extraction with forceps followed by EAC irrigation resulted in complete symptom resolution. The patient was discharged with recommendations for household pest control. This report highlights the appropriate management of live aural FBs and underscores the public health implications of domestic cockroach infestations. Conclusion: This case underscores the urgency of removing live external auditory canal foreign bodies, especially cockroaches which cause acute severe distress. The standard approach recommends immobilization prior to extraction while assessing tympanic integrity. Immediate extraction should be prioritized only in situations of severe distress. Public health measures prevent recurrence. Resource-limited settings may utilize adapted techniques (e.g., standard forceps) effectively when specialist care is inaccessible.