Does watching cartoons reduce anxiety in children undergoing cerumen aspiration? A randomized controlled study

This study aimed to evaluate whether watching age-appropriate cartoons during cerumen aspiration reduces anxiety and pain levels in pediatric patients.

A prospective randomized controlled study was conducted between December 2024 and July 2025, including 77 children (aged 4-10 years) undergoing cerumen aspiration. Patients were randomized into two groups: Group 1 received verbal explanation and efforts to establish trust before the procedure; Group 2 received the same preparation, followed by cerumen aspiration while watching an age-appropriate cartoon on a tablet. Anxiety was assessed using the Animated Emoji Faces Scale, and pain was measured with the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Statistical analyses were performed using independent-sample t-tests in SPSS v24, with p < 0.05 considered significant.

Of the 77 participants, 33 were in the cartoon group and 44 in the control group. The mean age was 7.09 years in the cartoon group and 6.68 years in the control group. Mean FLACC scores were 2.55 in the cartoon group and 3.43 in the control group (p = 0.189). Mean Emoji scores were 2.52 and 2.70, respectively (p = 0.514).

Watching cartoons during cerumen aspiration did not significantly reduce anxiety or pain levels in children, although a slight trend toward lower scores was observed in the video group. Larger-scale studies may help clarify the potential role of distraction techniques in reducing procedural anxiety in pediatric otolaryngology.