Managing earwax in primary care: efficacy of self-treatment using a bulb syringe
Coppin, Richard, Wicke, Dorothy and Little, Paul (2008) Managing earwax in primary care: efficacy of self-treatment using a bulb syringe. British Journal of General Practice, 58, (546), 44-49. (doi:10.3399/bjgp08X263811).
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Background: irrigating ears to remove wax is a time-consuming procedure in UK primary care. In many other countries bulb syringes are used for self-clearance of earwax but evidence of their effectiveness is lacking.
Aim: to compare the effectiveness of self-treatment bulb syringes with routine care. Design of study Open, randomised, controlled trial. Setting Seven practices in Hampshire, UK.
Method: participants were 237 patients attending their GP or practice nurse with symptomatic occluding earwax. A further 128 patients did not want to be part of the randomisation but allowed their data to be analysed. Patients randomised to intervention (n = 118) were given ear drops, a bulb syringe, and instructions on its use. Patients in the control group (n = 119) received ear drops, followed by ear irrigation by the GP or practice nurse. Main outcome measures were symptoms (on a 7-point scale), wax clearance, need for further treatment, and the acceptability of treatment.
Results: comparing patients using the bulb syringe with those treated with conventional irrigation, the change in mean symptom score was -0.81 and -1.26 respectively (difference -0.45, 95% confidence interval [CI] = -0.11 to -0.79) and, regarding the proportion requiring no further irrigation, 51 % and 69% respectively. Although irrigation was preferred by more patients, most patients using the bulb syringe would use it again (75% versus 100%) and were satisfied with treatment (71 % versus 99%).
Conclusions: advising patients with ears blocked by wax to try bulb syringing before irrigation is effective and acceptable, and could significantly reduce the use of NHS resources
|Keywords:||irrigation, design, practitioners, primary-care, england, treatment, london, cerumen, patients, adult, ear canal, trial, family practice, controlled-trial, time, surgery, symptoms|
|Subjects:||R Medicine > R Medicine (General)|
|Divisions:||University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
|Date Deposited:||09 Sep 2008|
|Last Modified:||01 Jun 2011 02:52|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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