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Cerumen: A fundamental but neglected problem by pediatricians
Paola Marchisio1, Carlotta Pipolo2, Massimo Landi3
1Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Summary
Cerumen (earwax) is highly prevalent in children, affecting over 70%. Pediatricians rarely remove earwax, unlike specialists, potentially impacting diagnosis and treatment.
Area of Science:
- Pediatrics
- Otolaryngology
- Public Health
Background:
- Cerumen (earwax) impaction results from a failure of the ear canal's self-cleaning mechanism.
- Limited data exist on cerumen prevalence in pediatric populations.
- Understanding cerumen prevalence and removal practices is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To determine the prevalence of cerumen in a large pediatric population.
- To compare cerumen removal practices between pediatricians and otorhinolaryngologists.
- To highlight potential impacts on diagnosis, especially for acute otitis media.
Main Methods:
- A cross-sectional study of 819 children (1 month to 12 years) visiting clinics for respiratory infections or well-being checks.
- Data collected included cerumen presence, laterality, amount, presenting complaints, diagnosis, and physician type.
- Physician type (pediatrician vs. otorhinolaryngologist) and cerumen removal attempts were recorded.
Main Results:
- Cerumen was present in 72.5% of children, with higher prevalence in younger, African, or Asian children.
- Significant differences in cerumen removal rates were observed: pediatricians removed it in 28.8% of cases, while otorhinolaryngologists removed it in 91.0%.
- Pediatricians removed cerumen in only 31.6% of children diagnosed with acute otitis media, compared to 95.6% by otorhinolaryngologists.
Conclusions:
- Cerumen is highly prevalent in both healthy and sick children.
- Pediatricians demonstrate significantly lower rates of cerumen removal compared to otorhinolaryngologists.
- Educational interventions are needed to improve pediatricians' cerumen removal techniques and awareness, particularly for acute otitis media cases, to prevent misdiagnosis and inappropriate treatment.
