Ear drops for the removal of ear wax

Abstract

Trials have been heterogeneous and generally of low or moderate quality, making it difficult to offer any definitive recommendations on the effectiveness of cerumenolytics for the removal of symptomatic ear wax. Using drops of any sort appears to be better than no treatment, but it is uncertain if one type of drop is any better than another. Future trials should be of high methodological quality, have large sample sizes, and compare both oil-based and water-based solvents with placebo, no treatment or both.

Ear care: an update for nurses (part 1)

“…There is limited evidence as to the most effective cerumenolytic to use (Schwartz et al, 2017) but it is likely that proprietary preparations may increase the risk of adverse dermatological reactions (Burton and Doree, 2009). Water or saline may be as effective as proprietary softening agents but may cause swelling of any keratin or organic foreign body present within the external auditory meatus (EAM), thus creating further complications and patient discomfort (Wright, 2015).…”

“…These should be instilled twice daily for up to one week before reassessing the need for irrigation. Where tolerated, or where irrigation may be contraindicated or undesirable to the patient, patients can use olive oil drops for up to three weeks as this may lead to sufficient resolution of impacted cerumen (Burton and Doree, 2009) through natural expulsion, negating the need for irrigation entirely.…”

“…It should be noted that Wright (2015) lists permanent hearing loss in the non-affected ear as a contraindication for irrigation on the basis that there is a rare but serious risk of permanent hearing loss in that ear, resulting in complete deafness. However, this is not discussed in other guidance (Burton and Doree, 2009;Schwartz et al, 2017) and the PECC (2017) specifically states that permanent hearing loss in the unaffected ear is NOT a contraindication as the risk of permanent hearing loss is outweighed by the benefits of cerumen removal and resultant improvement in hearing. Nurses should use their own clinical judgement in discussion with the patient in this situation.…”

“…Despite the scale of cerumen-related ear conditions in primary care there is still poor evidence to support current best practice recommendations (Burton and Doree, 2009;Loveman et al, 2011;Wright, 2015). In 2009 there was a Cochrane Systematic Review of cerumenolytics (Burton and Doree, 2009) which revealed only nine trials suitable for inclusion.…”

“…In 2009 there was a Cochrane Systematic Review of cerumenolytics (Burton and Doree, 2009) which revealed only nine trials suitable for inclusion. In 2011 Loveman et al undertook a further systematic review of all interventions including cerumenolytics and ear irrigation and found twenty-six suitable trials.…”