Cerumen impaction: Challenges and management profile in a rural health facility

Cerumen impaction is a worldwide problem. It constitutes a significant proportion of health problems in many settings and its prevalence varies. Very few studies were done in this region with none from our center. The aim of this study is to review the challenges and management profile of cerumen impaction in a rural health facility in Nigeria.

This was a 3-year retrospective study of all patients that were managed for cerumen impaction from June 2008 to May 2011, in the Department of Otorhinolaryngology, Federal Medical Centre, Ido-Ekiti, Nigeria.

A total of 239 patients, aged 3-98 years were managed for cerumen impaction. The male: female ratio was 1.6:1. The age group 1-20 years was mostly affected in 29.3%. Major complaints were hearing impairment in 120 cases. Both ears were mostly affected in 48.5% of the patients. Olive oil was a major ceruminolytic agent used in 95.4%. Ear syringing was carried out in 91.2% of cases. Major complications were bruises of external auditory canal and otalgia in 7.3% of cases each. Forty-two (17.8%) of our patients were asymptomatic, and they did not complained of ear problem. Out of those patients that were symptomatic, 44.3% had visited general medical practitioners and non-otolaryngologist, while 27.6% had self-medication or visited chemist for their ear complaints. Only 3.7% of them had been seen by ear, nose, and throat (ENT) specialist in the past.

Cerumen impaction is a common otolaryngological problem that presents to ENT surgeon, children, and elderly are more affected. Hearing impairment is the major complaint which may increase the burden of disability on society. Syringing is the most common mode of treatment of our patients. Continuing medical education, proper otological examination by the non-otolaryngologist and public health education to improve the low level of awareness on danger of self-medication is essential.