Effect of cotton-tipped swab use on ear-wax occlusion

We studied parents' and patients' approach to earwax (cerumen) removal, patients' level of cerumen occlusion, and the association between the use of cotton-tipped swabs (CTS) and cerumen occlusion. Six hundred fifty-one consecutive patients from the general pediatric practice of the Cleveland Clinic aged 2 weeks to 20 years (57% males) answered a questionnaire with their parents' help. Of the 651, 401 (62%) had used CTS during the 2 months before the study. Examiners unaware of the questionnaire results found that 46 (7%) of both right and left ear canals were at least 75% occluded by cerumen. Cerumen occlusion of at least 75% was associated with CTS use on the left side (P = .02), but not on the right side (P = .27). We conclude that cotton-tipped swab use may be associated with cerumen accumulation.