Neglected middle ear foreign body with unusual eustachian tube migration; case report

Foreign bodies in the ear, nose, and throat are common presentations that may carry a significant risk of complications. Middle ear foreign bodies are less frequently encountered and are most often associated with direct tympanic membrane perforation or iatrogenic causes, such as displaced tympanostomy tubes. In this report, we describe a case of a long-standing graphite pencil tip found within the middle ear, with a possible migration route through the Eustachian tube. This case highlights an unusual mechanism of entry and underscores the importance of careful evaluation in patients with chronic otologic symptoms.