Searching for the Holy Grail among ear drops
DOI:
https://doi.org/10.12775/JEHS.2024.74.52558Keywords
cerumen, hygiene, cerumenolytic agentsAbstract
Introduction and aim of the study: Ear wax plays many roles in maintaining ear health, such as cleansing, shielding, and lubricating the external auditory canal. Sometimes, when earwax obstruction occurs, for example as a result of improper hygiene procedures (such as using cotton swabs), it can cause a number of disorders ranging from discomfort to even loss of hearing. In such cases, various methods can be used to remove the cerumen impaction. One of these and also the most commonly used, involves the usage of ear drops, which can contain different active substances (water-based compounds, oil-based compounds, a combination of oil and water-based compounds, and non-water, non-oil solutions). The aim of our study is to present current state of knowledge about effectiveness of various types of ear drops in wax cleaning.
Material and methods: Our review is based on the analysis of materials collected in Pubmed”, „Google Scholar” and other scientific articles using keywords: „earwax”, cerumen impaction”, „cerumenolytics”, „ear drops”, „cerumen”, „earwax solvents”, „wax solvents”.
Conclusions: Despite numerous studies, the Holy Grail has not been found among ear drops. The majority conducted studies did not show that any of the cerumenolitics were superior to the others in a statistically significant way. The only result that was statistically significant was the one showing a higher effectiveness of 2.5% sodium bicarbonate compared to docusate sodium. Further research is needed.
References
Fridose S, Poduval JD. Aural health: knowledge, attitude and practice. Int J Sci Reports. 2015;1(1):36. doi:10.18203/issn.2454-2156.intjscirep20150198
Adegbiji W, Alabi B, Olajuyin O, Nwawolo C. Earwax impaction: Symptoms, predisposing factors and perception among Nigerians. J Fam Med Prim Care. 2014;3(4):379. doi:10.4103/2249-4863.148116
Martin A. How to maintain healthy ears, 2013. Available at: http://www.hygieneexpert.co.uk/howmaintain-healthy-ears.html. Accessed 15 May 2024.
Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical Practice Guideline (Update). Otolaryngol - Head Neck Surg (United States). 2017;156(1_suppl):S1-S29. doi:10.1177/0194599816671491
Burton MJ, Doree C. Ear drops for the removal of ear wax. Cochrane Database Syst Rev. 2018;2018(7). doi:10.1002/14651858.CD004326.pub3
Lukolo LN, Kimera LC, Pilbee G. Self-Ear Cleaning Practices and the Associated Risks: A Systematic Review. Glob J Health Sci. 2021;13(5):44. doi:10.5539/gjhs.v13n5p44
Poulton S, Yau S, Anderson D, Bennett D. Ear wax management. Aust Fam Physician. 2015;44(10):731-734.
Alkishi S, Alben saad G, Albattat M, BoKheder M, Alyahya K, Alarfaj A. Self-Ear Cleaning Practice And The Associated Risk Of Ear Injuries And Ear-Related Symptoms In Saudi Arabia. J Pharm Negat Results. 2022;13(09):6873-6883. doi:10.47750/pnr.2022.13.S09.816
Tolan MM, Choi JS, Tibesar MT, Adams ME. Cerumen impaction: Prevalence and associated factors in the United States population. Laryngoscope Investig Otolaryngol. 2024;9(2):1-10. doi:10.1002/lio2.1228
Alshehri A, Asiri K, Alahmari M, Alwabel H, Alahmari Y, Mahmood S. Knowledge, attitudes, and practices of self-ear cleaning among medical and nonmedical students at King Khalid University, Abha, Saudi Arabia. Int J Med Dev Ctries. 2020;4(April):960-967. doi:10.24911/ijmdc.51-1584110722
Adobamen PR, Ogisi FO. Hearing loss due to wax impaction. Nig Q J Hosp Med. 2012;22(2):117-120..
Khan NB, Thaver S, Govender SM. Self-ear cleaning practices and the associated risk of ear injuries and ear-related symptoms in a group of university students. J Public Health Africa. 2017;8(2):149-154. doi:10.4081/jphia.2017.555
Oladeji SM, Babatunde OT, Babatunde LB, Sogebi OA. Knowledge of Cerumen and Effect of Ear Self-Cleaning Among Health Workers in a Tertiary Hospital. J West African Coll Surg. 2015;5(2):117-133.
Olaosun A. Self‑ear‑cleaning among educated young adults in Nigeria. J Fam Med Prim Care. 2014;3(1):17. doi:10.4103/2249-4863.130262
Nussinovitch M, Rimon A, Volovitz B, Raveh E, Prais D, Amir J. Cotton-tip applicators as a leading cause of otitis externa. Int J Pediatr Otorhinolaryngol. 2004;68(4):433-435. doi:10.1016/j.ijporl.2003.11.014
McCarter DF, Courtney AU, Pollart SM. Cerumen impaction. Am Fam Physician. 2007;75(10):1523-1528. doi:10.3109/9780849374487-5
Oladeji S, Babatunde O, Adenekan A, Nwawolo C, Uche-Okonkwo K, Johnson K. Self ear cleaning among health workers in Nigeria. IOSR J Dent Med Sci. 2015;14(8):1-5. doi:10.9790/0853-1485122126
National Institute for Health and Care Excellence. Hearing loss in adults: assessment and management. NICE Guidel. 2023;28(June 2018):20.
Horton GA, Simpson MTW, Beyea MM, Beyea JA. Cerumen Management: An Updated Clinical Review and Evidence-Based Approach for Primary Care Physicians. J Prim Care Community Heal. 2020;11. doi:10.1177/2150132720904181
Munro KJ, Giles TC, Smith-Howell C, Nazareth I. Ear wax management in primary care: What the busy GP needs to know. Br J Gen Pract. 2023;73(727):90-92. doi:10.3399/bjgp23X732009
Asgari A, Asgari HR, Ghorbanlou M, Dobakhti F, Ghorbanian MA. Cerumenolytic Effects of Carbamide Peroxide in Patients with Ear Wax Obstruction. Iran J Otorhinolaryngol. 2024;36(2):415-420. doi:10.22038/IJORL.2024.67777.3311
Robinson AC, Hawke M, MacKay A, Ekem JK, Stratis M. The mechanism of ceruminolysis. J Otolaryngol. 1989;18(6):268-273.
Hand C, Harvey I. The effectiveness of topical preparations for the treatment of earwax: A systematic review. Br J Gen Pract. 2004;54(508):862-867. doi:10.1016/s1041-892x(08)70060-x
Keane EM, Wilson H, McGrane D, Coakley D, Walsh JB. Use of solvents to disperse ear wax. Br J Clin Pract. 1995;49(2):71-72.
Meyer F, Preuß R, Angelow A, Chenot JF, Meyer E, Kiel S. Cerumen Impaction Removal in General Practices: A Comparison of Approved Standard Products. J Prim Care Community Heal. 2020;11. doi:10.1177/2150132720973829
Meehan P. Ceruminolysis in the Pediatric Patient: A Prospective, Double-blinded, Randomized Controlled Trial. Acad Emerg Med. 2002;9.
Whatley VN, Dodds CL, Paul RI. Randomized clinical trial of docusate, triethanolamine polypeptide, and irrigation in cerumen removal in children. Arch Pediatr Adolesc Med. 2003;157(12):1177-1180. doi:10.1001/archpedi.157.12.1177
Jaffé G, Grimshaw J. A multicentric clinical trial comparing Otocerol with Cerumol as cerumenolytics. J Int Med Res. 1978;6(3):241-244. doi:10.1177/030006057800600312
Singer AJ, Sauris E, Viccellio AW. Ceruminolytic effects of docusate sodium: a randomized, controlled trial. Ann Emerg Med. 2000;36(3):228-232. doi:10.1067/mem.2000.109166
Piromchai P, Laohakittikul C, Khunnawongkrit S, Srirompotong S. Cerumenolytic Efficacy of 2.5% Sodium Bicarbonate Versus Docusate Sodium: A Randomized, Controlled Trial. Otol Neurotol. 2020;41(7).
Burgess EH. A wetting agent to facilitate ear syringing. Practitioner. 1966;197(182):811—812.
Dummer DS, Sutherland IA, Murray JA. A single-blind, randomized study to compare the efficacy of two ear drop preparations (“Audax” and ’Cerumol’) in the softening of ear wax. Curr Med Res Opin. 1992;13(1):26-30. doi:10.1185/03007999209115219
Lyndon S, Roy P, Grillage MG, Miller AJ. A comparison of the efficacy of two ear drop preparations (“Audax” and ’Earex’) in the softening and removal of impacted ear wax. Curr Med Res Opin. 1992;13(1):21-25. doi:10.1185/03007999209115218
Oron Y, Zwecker-Lazar I, Levy D, Kreitler S, Roth Y. Cerumen removal: comparison of cerumenolytic agents and effect on cognition among the elderly. Arch Gerontol Geriatr. 2011;52(2):228-232. doi:10.1016/j.archger.2010.03.025
Anh NQ, Numthavaj P, Bhongmakapat T. Comparison of the Cerumenolytic Activities of New and Currently Used Agents. Ear, Nose Throat J. 2022;101(2):31S-36S. doi:10.1177/0145561320986060
Fraser JG. The efficacy of wax solvents: in vitro studies and a clinical trial. J Laryngol Otol. 1970;84(10):1055-1064. doi:10.1017/s0022215100072856
Srisukhumchai C, Kasemsiri P, Rattanaanekchai T, Srirompotong S, Yordpratum U, Sakolsinsiri C. A comparative in vitro study on the cerumenolytic effect of docusate sodium versus 2.5% sodium bicarbonate using UV–visible absorption spectroscopy. J Otol. 2020;15(3):99-102. doi:10.1016/j.joto.2019.09.001
Clegg AJ, Loveman E, Gospodarevskaya E, et al. The safety and effectiveness of different methods of earwax removal: A systematic review and economic evaluation. Health Technol Assess (Rockv). 2010;14(28). doi:10.3310/hta14280
Wright T. Ear wax. BMJ. 2015;351:h3601. doi:10.1136/bmj.h3601
Chalishazar U, Williams H. Back to basics: finding an optimal cerumenolytic (earwax solvent). Br J Nurs. 2007;16(13):806-808. doi:10.12968/bjon.2007.16.13.24247
Sevy JO, Hohman MH, Singh A. Cerumen Impaction Removal. In: StatPearls. Treasure Island (FL): StatPearls Publishing; March 1, 2023.
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