Earwax and level of paralysis

Inception cohort.

The clinical impression that earwax is uncommonly frequent among spinal cord injury patients with high levels of paralysis was tested.

Veterans Administration Hospital, USA.

A cohort of 15 chronically paralyzed patients, motor complete, living as residents in a long-term care facility was offered monthly irrigations of the ears for removal of wax over a 6-month period. The number of requests was tabulated. All ears were examined once on a single day to determine point prevalence. The accumulated wax graded as absent or small, moderate or large.

Two patients with C2 lesions, aged 37 and 52 years and paralyzed 15 and 16 years, were compared with 13 patients at C4-T6 aged 44-78 years, median 62 years, and paralyzed 2-33 years, median 24 years. Over a 6-month observation period, 10 irrigations were requested by the C2 patients and three by the C4-T6 patients. The reasons were hearing loss. Wax was found and removed, and symptoms were relieved in all instances, P&<0.001. The spot survey revealed earwax of moderate or large amounts in four of four C2 patient ears and in two of 24 C4-T6 patient ears, P=0.001.

Patients with C2 tetraplegia accumulate more earwax and request its removal more often than patients with lower levels of paralysis.