Occupational metallic foreign body in the hypotympanum: the critical role of timely treatment. Two case reports and a review of the literature.

BACKGROUND: We present two rare cases where a metal splinter became lodged in the middle ear (hypotympanum) as a result of occupational accidents. METHODS: Retrospectiveanalysis of two patients underwent surgical procedures for the removal of a metallic foreign body from the middle ear was reported. A systematicliterature review was conducted using PubMed. RESULTS: The patients reported symptoms of hearing loss, otorrhea, and vertigo following the injury. Temporalbone CT scans confirmed the presence of a foreign body in the hypotympanum in both cases. In the first case, the patient sought medical attentionpromptly and underwent a single surgical procedure: exploration of the tympanic cavity allowed removal of the foreign body, followed bymyringo-plasty. In contrast, the second patient delayed seeking treatment for 11 days, resulting in severe inflammation. This patient required two surgicalinterventions, the second involving mastoidectomy, to extract the foreign body. This highlights the need for improved occupational health safetymeasures, particularly in professions at risk for such injuries, and emphasizes the importance of timely medical care for optimal outcomes. CONCLUSION: Delayedt reatment can lead to complications, necessitating more complex surgical procedures and prolonged recovery. Early diagnosis and timely surgicalmanagement are essential to minimize complications and preserve auditory function.