Are earbuds good or bad for cleaning earwax? what do ENT doctors across the world suggest?

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Is it safe to clean ear wax by using cotton swabs or earbuds? What do doctors say?

The ear is a complex, powerful, and delicate organ. It collects sound waves so you can hear the world around you. The ear also has a second function-it helps you keep your balance.

If a person has ear wax (cerumen) in the ear canal and uses buds to clean it, then instead of cleaning cerumen, it pushes it deep in the canal. This impacted cerumen causes severe ear pain and hearing loss, warn doctors.

Inserting any object from a pin, finger to even a cotton bud or Q-tip in the ear is a risky thing to do as it pushes the ear wax further deep into the ear canal.

We find earbuds easy to use as they are available in shops over the counter. It seems convenient and saves us the effort of going to a specialist. You must know that this very dangerous practice can even cause hearing loss because the eardrum is extremely sensitive and can be ruptured even with the slightest pressure from the seemingly harmless earbud.

ENT scene in the UAE:
Dr Naveen Gupta, ENT specialist at Zulekha Hospital, Dubai tells the Khaleej Times: “There is no specific age bracket for wax accumulation as it is not a disease. Wax accumulation can start to form in babies a few months old to elderly people.

“Wax is a normal thing to form in the ear as it is a mixture of the ear skin secretions, dead cells of the skin and trapped foreign bodies. It lubricates the ear skin and prevents dryness and infections. As it forms, it clears out in the particle form from the ear canal on its own. In some people, it forms more, or its movement is not fast enough leading to accumulation in the ear canal. These people need to consult an ENT specialist for its removal.”

ENT doctors in the US:
To a question whether one may use cotton swab earbuds to clean the ears, Dr Wong at the Cedars Sinai Hospital (USA) says, “No! It says so right on the back of the box: DO NOT USE IN EARS! Using a cotton swab like a plunger in the ear canal pushes the earwax deeper and deeper in. One problem is that if you push the wax deeper inside, there’s no way for the wax to get swept out of the ear.”

What damage can the cotton swabs do to the human ear?
Puncture the eardrums
Cause hearing loss
In severe cases, the cotton swab can damage many sensitive structures behind the ear canal.
This damage can lead to complete deafness, prolonged vertigo with nausea and vomiting, loss of taste function, and even facial paralysis.

Dr Wong also warns against the forceful removal of ear wax.
He says, “Earwax, also known as cerumen, is a natural substance that your body makes and has many beneficial properties-it is slightly acidic, which helps fight bacteria and fungus in the ear, and it’s slightly oily, which provides a waterproof barrier for the ear canal skin.

“You usually don’t need to ever clean wax out of your ears because there’s a natural cleaning system in the ear canal that sweeps earwax out like a conveyor belt. Even if there is a lot of wax, you can have up to 90% of your ear canal blocked and still be able to hear clearly since you only need a small pinhole for sound to travel through,” Dr Wong said.

How do doctors remove was from a person’s ears?
In some situations, the ear does make an excessive amount of wax or earwax build-up occurs for some other reason. In those cases, primary care physicians often use an ear lavage, where warm water is flushed into the ear canal to gently wash away the wax.

What about the patients with an eardrum injury?
Physicians exercise caution if the patient has a hole in the eardrum or active infection, as excess water can cause pain and drainage, warns Dr Wong.

No syringing ear with water: UK doctors
But doctors in the UK insist that are blocked with wax should not be syringed. For thousands of years, the syringe has been the ear doctor’s tool of choice (Roman author Celsus wrote about it in De Medicina), but now a UK health watchdog says that a syringe pumping water into the ear is “potentially harmful”.

Why is it so, one may ask.

“You can’t control the pressure; you don’t know how hard it is blasting water into the ear,” says Prof Tony Wright of the UCL Ear Institute. Electronic irrigators, which Nice recommends, allow the otolaryngologist (ear, nose and throat specialist) to control pressure, but they are still only an update of the syringe.

ENT UK, the association for ear, nose and throat doctors, does not recommend the irrigation method at all.
“ENT surgeons all believe the best way to remove wax is under direct vision with a little suction device,” says Wright. Ask your GP to refer you. Private clinics offer this micro-suction service – a microscope with a powerful sucker, report the Guardian (UK).

Indian ENTs:
In India, doctors adopt either of the three methods. In case of hard and dry extensive wax, the softening of wax can be achieved by repeated instillation of wax softening ear drops into the outer ear for 3-4 days and then cleaning by suction, reports The Times of India. It cites Dr BM Abrol, Consultant ENT Specialist at Pushpawati Singhania Research Institute, New Delhi, who mentions 3 techniques:

  1. Syringing with sterile water at body temperature,
  2. Removal of wax with forceps, hooks and probes, and
  3. Cleaning by suction (vacuum)

As for cases where the wax has hardened and dried up, Dr Abrol says that the softening of wax can be achieved by repeated instillation of wax softening ear drops into the outer ear for 3-4 days and then cleaning by suction. Most of the cases can be tackled with an anaesthetic, Dr Abrol says. However, in children and apprehensive adults, one may occasionally have to resort to general anaesthesia.

Bottom line:
Put down the cotton buds. Now.

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