By Andrew M. Seaman
(Reuters Health) - Small beads that expand in water and are often marketed as toys have the potential to cause hearing loss if the products get lodged in children’s ears, according to a new report.
“The general rule is for kids under six years of age, these are the things I would keep out of the home,” said Dr. Gary Smith, who is president of the Child Injury Prevention Alliance.
Parents of older children using these types of super-absorbent polymer beads should keep track of the objects “so nothing bad happens,” said Smith, who was not among the authors of the new report.
Super-absorbent polymer beads, which start out small and expand in water, were originally developed to be used for planting, but eventually became a popular toy for children.
In 2012, doctors from Texas Children’s Hospital in Houston described in the journal Pediatrics the case of an eight-month-old girl who swallowed a super-absorbent polymer bead; about 15 hours later, it had become lodged in her gut.
The bead expanded to about the size of a golf ball and required surgery to remove. As a result, the U.S. company Dunecraft recalled over 90,000 similar toys known as Water Balz, Growing Skulls, H2O Orbs “Despicable Me” and Fabulous Flowers toys.
In a new letter in JAMA Otolaryngology-Head and Neck Surgery August 4, Dr. Megan Sterling and Dr. Pamela Muss of Children’s National Medical Center in Washington, D.C., describe two children who had super-absorbent beads expand in their ear canals.
In one case, a girl had been having ear problems for more than 10 weeks that were not clearing up with antibiotics or ear drops. An MRI revealed a 10-millimeter ball that had expanded in her ear. The gelatinous green ball was removed from her middle ear during surgery, but the child developed “profound” hearing loss.
In the second case, a boy also required surgery to remove a gelatinous blue super-absorbent bead from his ear canal. This child’s hearing loss was milder and reversible.
The products - from an unknown manufacturer - also resulted in eardrum perforation and damage to the bones in the ear.
One popular brand of super-absorbent beads is known as Orbeez, which is manufactured and sold by Maya Toys.
Orbeez are small enough to pass through the digestive system, according to Oded Ben-Ezer, who owns Maya Toys.
“In terms of the ears and nose, we have had incidents in the past,” he told Reuters Health. “On our package we say don’t eat and don’t put it in the ears or nose.”
While there have been incidents of children and pets eating Orbeez, Ben-Ezer is unaware of injuries like those described in the reports.
Smith, who is also director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, said these expanding beads have “a high risk shape and high risk size.”
Healthcare providers should consider super-absorbent materials when treating people with foreign objects stuck in their ear canals, Sterling and Muss write in their letter.
Trapped super-absorbent balls should not be treated with ear drops, they write. Patients should be told to keep the ear dry and seek an urgent evaluation from an ear, nose and throat expert.
JAMA Otolaryngol Head Neck Surg 2016.