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), pp. 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

Item Type: Article
Digital Object Identifier (DOI): doi:10.3399/bjgp08X263811
ISSNs: 0960-1643 (print)
Related URLs:
Keywords: irrigation, design, practitioners, primary-care, england, treatment, london, cerumen, patients, adult, ear canal, trial, family practice, controlled-trial, time, surgery, symptoms
ePrint ID: 61740
Date :
Date Event
January 2008Published
Date Deposited: 09 Sep 2008
Last Modified: 16 Apr 2017 17:30
Further Information:Google Scholar

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