Jah. Eekhof et al., A quasi-randomised controlled trial of water as a quick softening agent ofpersistent earwax in general practice, BR J GEN PR, 51(469), 2001, pp. 635-637
Background. Earwax is a common problem in general practice, The incidence o
f complaints owing to earwax in general practice in the Netherlands is 39.3
per 1000 patients.
Aim: To determine the feasibility of a strategy using water as a,for persis
tent earwax, compared with the usual quick dispersant strategy using oil as
a dispersant for three days in a general practice setting.
Design of study. Practice based, prospective controlled intervention study,
Setting.. Forty-two patients (59 ears) in four general practices in the Net
herlands.
Method. Patients with persistent earwax were randomised into an interventio
n group and a control group. For patients in the intervention group, water
drops at body temperature were dropped into the impacted ear and the audito
ry meatus was blocked with a wet wad of cotton, After the patient had waite
d for 15 minutes in the waiting room a series of attempts at syringing was
completed. Patients in the control group received the usual strategy and we
re instructed to soften the earwax with oil each night before sleeping and
to block the auditory meatus with a wad of cotton, for three days. They wer
e asked to come back after three days for the second attempt of syringing.
For both strategies the mean number of syringing attempts (and 95% confiden
ce interval) was calculated and compared by testing the difference between
the means using a t-test for independent samples. All ears in which the wax
was still persistent after another five syringing attempts were given the
value of 6 in the calculations.
Results. The mean number of syringing attempts needed per patient in the in
tervention group was 3.0 (95% CI = 2.4 to 3.6) and for the control group, t
he mean was 2.4 (95% CI = 1.7 to 3.1). The difference between means (0.6, 9
5% CI = 0.3 to 1.5) was not statistically significant (P = 0.18).
Conclusion. A patient with persistent earwax can stay in the waiting room f
ollowing the initial series of five attempts at syringing, with water insti
lled in the ear canal, After 15 minutes, the earwax is removed as easily as
in the usual strategy using oil,for three days. The strategy using water a
s a dispersant instilled for persistent earwax is quick and more convenient
for the patient.