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Ear wax removal: a survey of current practice
J F Sharp1, J A Wilson, L Ross
1Department of Otolaryngology, Royal Infirmary, Edinburgh.
BMJ (Clinical Research Ed.)
|December 1, 1990
Summary
General practitioners frequently delegate ear wax removal to nurses, leading to complications in 38% of cases. Improved training and patient selection can reduce these risks.
Area of Science:
- Otolaryngology
- General Practice
- Healthcare Management
Background:
- Ear wax (cerumen) impaction is a common condition managed in primary care.
- Current practices for ear wax removal by general practitioners (GPs) and associated complication rates are not well-documented.
Purpose of the Study:
- To investigate the methods employed by GPs for ear wax removal.
- To determine the incidence of complications associated with these ear wax removal procedures.
Main Methods:
- A postal survey was conducted among 312 GPs in Edinburgh.
- A supplementary study assessed hearing improvement in 21 ear, nose, and throat (ENT) outpatients post-wax removal.
Main Results:
- Syringing is the predominant method (95% of GPs), but only 19% perform it themselves, with most delegating to nurses.
- Complications, including perforation and laceration, were reported by 38% of GPs.
- Ear wax removal improved hearing by an average of 5 dB.
Conclusions:
- An estimated 44,000 ear syringing procedures occur annually in the area.
- Complications requiring specialist referral are estimated at 1 in 1000 procedures.
- Reducing complications necessitates increased awareness, better staff training, and careful patient selection.
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