By Chioma Obinna

Worldwide, several studies have pointed to the growing problems arising from self-ear-cleaning. Even in Nigeria, researchers have demonstrated that good intention of caring for the ears may weaken the ability to hear and thereby cause more harm than goodDoctors are of the view that cotton buds, hair pins, house keys and broomsticks people usually put in their ears can cut the ear canals, perforate the eardrums and dislocate hearing bones.

The ear is a sensitive body part and any damage to this all-important  organ could be disastrous.

It has been adjudged by doctors as a delicate and intricate part of the body, including the skin of the ear canal and the eardrum.  They maintain that the nature of the ear attracts special care. Sadly, in the course of keeping to this special care, individuals end up causing more harm to the delicate body part.

Self-ear-cleaning, which is the insertion of objects into one’s own ears purportedly to clean them, is almost universal.  From several hospital-based studies, it has been reported to be common and has been associated with some diseases of the ear.   A study on “Self-Ear-Cleaning Among Educated Young Adults in Nigeria” carried out by Adedayo Olugbenga Olaosun, showed that 90 percent of respondents practiced self-ear-cleaning and most of those who do this believe that for ear hygiene, it is necessary to remove excess earwax.

It is also a common knowledge that attempting to clean wax out of the ear with swabs is one habit that everyone feels good to do. It is also a practice that you don’t feel complete if you don’t do it particularly after a bath.

However, critical health watchers are worried that most of the population is at risk of possible harmful effects because medical advice against self-ear-cleaning is not widely known. Rather, what is common is the erroneous perception that self-ear-cleaning is beneficial.

Meanwhile, the latest pronouncement by experts from the American Academy of Otolaryngology – Head and Neck Surgery-revealed that the habit of inserting cotton buds or other objects into the ear canals should be discontinued. These experts are of the view that wax blockage is one of the most common causes of hearing loss and it often caused by attempts to clean the ear with cotton bud.  To them, people should not put anything smaller than their elbow in the ear — including ear candles, which are supposed to remove wax with heat, though there’s no evidence yet.

 

The experts  explained that the wax is as beneficial as nose mucus or eyelashes and should be left alone as much as possible.

According to the experts, people should seek medical help if their ear feels full, painful, itchy, or if they are experiencing hearing loss, drainage, ringing in the ears, or bleeding, rather than using a cotton bud to poke around.

“The earwax, also known as cerumen, is healthy in normal amounts and serves as a self-cleaning agent with protective, lubricating, and antibacterial properties. The absence of earwax may result in dry, itchy ears”, the guidelines prepared by the reports said.

“Self-cleaning means there is a slow and orderly movement of earwax and dead skin cells from the eardrum to the ear opening. Old earwax is constantly being transported, assisted by chewing and jaw motion, from the ear canal to the ear opening where, most of the time; it dries, flakes, and falls out.”

The experts pointed out that earwax is not formed in the deep part of the ear canal near the eardrum but only formed in the outer one-third of the ear canal. So, when a patient has wax blockage against the eardrum, it is because he or she has been probing the ear with such things as cotton-tipped applicators, bobby pins, or twisted napkin corners among others and these objects only push the wax in deeper.

Corroborating the American expert guidelines, National President, Speech Pathology and Audiology Association of Nigeria, SPAAN, Prof. Julius Ademokoya, said the use of cotton bud for self-ear-cleaning is a common practice among people, particularly, in Nigeria despite its attendant ill-effects.

Ademokoya  added that self-cleaning in Nigeria has been associated with infections such as otitis externa, cerumen impaction, and injuries to the ear.

When you can clean the ears

The professor of speech and hearing rehabilitation stated that the ear canals should never have to be cleaned if possible but can be cleaned when enough earwax accumulates to cause symptoms or to prevent a needed assessment of the ear by the doctor.

In Nigeria, cerumen impaction is one of the reasons patients seek medical care for ear-related problems. It can affect up to six percent of the general population and a much higher percentage of the elderly and persons with cognitive impairment. In the study by  Olaosun, impacted cerumen is present in approximately 1 in 10 children, 1 in 20 adults, and 1 in 3 older adults.  In the United States, cerumen accumulation leads to 12 million patient visits and 8 million cerumen removal procedures annually.  Also, cerumen removal is the most common ear, nose, and throat (ENT) procedure performed in primary care.

Reasons you should not use cotton bud

Ademokoya, who explained that although the cotton bud has some level of advantages over sharp objects that could rupture the eardrum, it is not safe.

He said that, sometimes, attempts to clean the ear with cotton bud merely push the wax deeper into the ear canal, causing a blockage.

His words: “The outer ear is the funnel-like part of the ear that can be seen on the side of the head, plus the ear canal (the hole which leads down to the eardrum). The ear canal is shaped somewhat like an hourglass narrowing part way down. The skin of the outer part of the canal has special glands that produce earwax. This wax is supposed to trap dust and dirt particles to keep them from reaching the eardrum. Usually the wax accumulates a bit, dries out, and then comes out of the ear, carrying dirt and dust with it. Or it may slowly migrate to the outside where it can be wiped off

“We believe that cotton buds are a bit soft, cheaper and more accessible.  If you compare cotton bud against other things, you could say it is safer but not the best.  It is safer because other objects we have been using here, like biro, key, expose the ears to a lot of infections.  The problem with cotton bud is that it is usually not made according to recommended standards. In other words, the cotton is substandard and, in the process of using it to clean the canal, the cotton drops into the ear, thereby creating problems.  “The cotton bud is also exposed to all kinds of dirt, weather and unhygienic situations that could cause infections to the ear. As a result of it is  advised that it should be stopped.”

He recommended that people should consult ENT clinics for ear cleaning. “Your best option is to have your ears cleaned by the expert or an ENT nurse.”

Separately, health watchers have recommended collaborative health education efforts targeted at families and schools and campaigns and advocacy for legislation regulating the sale of the cotton bud.

New method of ear-cleaning

To clean the ear, experts say, wash the external ear with a cloth, but do not insert anything into the ear canal.

According to them, most cases of ear wax blockage respond to home treatments used to soften wax. Patients can try placing a few drops of mineral oil, baby oil, glycerine, or commercial drops in the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide available in pharmacies may also aid in the removal of wax.

Irrigation or ear syringing is commonly used for cleaning and can be performed by a physician or at home using a commercially available irrigation kit. Common solutions used for syringing include water and saline, which should be warmed to body temperature to prevent dizziness.

Ear syringing is most effective when water, saline or wax dissolving drops are put in the ear canal 15 to 30 minutes before treatment.   It is also not advised to have your ears irrigated if you have diabetes, a hole in the eardrum (perforation), tube in the eardrum, skin problems such as eczema in the ear canal or a weakened immune system.

Manual removal of earwax is also effective. This is most often performed by an otolaryngologist using suction or special miniature instruments, and a microscope to magnify the ear canal. Manual removal is preferred if your ear canal is narrow, the eardrum has a perforation or tube, other methods have failed, or if you have skin problems affecting the ear canal, diabetes or a weakened immune system.

When to see a doctor

If wax has accumulated so much that it blocks the ear canal (and hearing), a physician may prescribe eardrops designed to soften wax, or she may wash or vacuum it out. Occasionally, an otolaryngologist (ear, nose, and throat specialist) may need to remove the wax under microscopic visualization.

If there is a possibility of a perforation in the eardrum, consult a physician prior to trying any over-the-counter remedies. Putting eardrops or other products in the ear with the presence of an eardrum perforation may cause pain or an infection. Certainly, washing water through such a hole could start an infection.

Preventing excessive earwax

There are no proven ways to prevent cerumen impaction, but not inserting cotton-tipped swabs or other objects in the ear canal is strongly advised.  If you are prone to repeated wax impaction or use hearing aids, consider seeing your doctor every 6 to 12 months for a check-up and routine preventive cleaning.

Ear candles and removal of wax build-up

Experts say no and that ear candles are not a safe option of wax removal as they may result in serious injury.   The U.S. Food and Drug Administration (FDA) became concerned about the safety issues with ear candles after receiving reports of patient injury caused by the ear-candling procedure. There are no controlled studies or other scientific evidence that support the safety and effectiveness of these devices for any of the purported claims or intended uses as contained in the labelling.

Also, based on the growing concern associated with the manufacture, marketing, and use of ear candles, the FDA has undertaken several successful regulatory actions, including product seizures and injunctions, since 1996. These actions were based, in part, upon violations of the Food, Drug, and Cosmetic Act that pose an imminent danger to health.

What Is earwax build-up?

Your ear canal produces a waxy oil called cerumen, which is more commonly known as earwax. This wax protects the ear from dust, foreign particles, and microorganisms. It also protects ear canal skin from irritation due to water. In normal circumstances, excess wax finds its way out of the canal and into the ear opening naturally and then is washed away.  When your glands make more earwax than is necessary, it may get hard and block the ear. When you clean your ears, you can accidentally push the wax deeper, causing a blockage.

Causes of earwax build-up

Some people are prone to producing too much earwax. Still, excess wax doesn’t automatically lead to blockage. In fact, the most common cause of earwax blockage is at-home removal. Using cotton swabs, bobby pins, or other objects in your ear canal can also push wax deeper, creating a blockage.

 Symptoms of earwax build-up

The appearance of earwax varies from light yellow to dark brown. Darker colours do not necessarily indicate that there is a blockage.  Signs of earwax build-up include sudden or partial hearing loss, which is usually temporary, tinnitus, which is a ringing or buzzing in the ear, a feeling of fullness in the ear, earache, and unremoved earwax build-up can lead to infection. Contact your doctor if you experience these seven  symptoms: Pain in your ear that does not subside, drainage from your ear, fever, coughing, persistent hearing loss, an odour coming from your ear and dizziness.

 

 

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