Cotton buds, hairpins, pencils, toothpicks and lollipop sticks

The items people have used to remove earwax and ruptured their eardrums

The majority of eardrum perforations are caused by people injuring themselves with cotton buds, hairpins, toys, combs, pencils, straws, toothpicks and lollipop sticks, a new study has revealed.

Two thirds of patients treated for the injury had stuck 'instruments,' in their ears found researchers from the University of Toronto. Nearly half of these cases involved cotton buds.

Many of the patients seen did not realise the objects they had used to poke inside their ear canal could cause injury, push earwax further in, or even burst their eardrum, the authors of the study warned. The findings come after British health watchdog NICE (National Institute for Health and Care Excellence) issued a warning that cotton buds are a ‘hazard’ to ears.

A ruptured eardrum is a hole or tear in the thin tissue that separates your ear canal from your middle ear. While it usually heals within a few weeks without treatment, it can result in hearing loss and also make your middle ear vulnerable to infections or injury.

Study findings

Researchers looked at five years of records from 100 emergency departments in the US and found over 900 visits for ear-related injuries.

'In our experience, cotton tip applicators (Q-tips) are frequently the instrument that patients will use to clean their ears,' lead author Dr. Eric Carnoil, an otolaryngologist at the University of Toronto, told Reuters Health.

' Our conjecture is that the majority of these injuries were caused by patients trying to get their own ear wax out,' he said.

The tympanic membrane, or eardrum, is a structure that transmits sounds from the outer ear to the bones inside the ear, and perforating the membrane can lead to hearing loss, Dr. Carnoil and his colleagues wrote in the j o u r n a l JAMA Otolaryngology Head & Neck Surgery. Otolaryngologists see many patients in the office with eardrum perforations that are most often caused by ear infections or trauma, he noted.

The study focused on the traumatic causes of eardrum perfo- rations. Many patients do not realise they can injure the ear canal, push earwax further in (impaction), or even burst their eardrum, he said.

Besides cotton swabs, other objects included hairpins, toys, combs, pencils, straws, toothpicks and lollipop sticks. Water activity, such as water skiing and diving, was also a cause of injuries.

How to clean your ears

Reuters also spoke to Dr. Hamid Djalilian, a professor of clinical otolaryngology at the University of California, Irvine, who wasn't involved in the research. He said: 'A little bit of wax will stick to the Q-tip and make the user feel great about themselves that they accomplish something, but chances are approximately five to 10 times more wax was pushed in.

Using Q-tips (or other things) in the ear canal is also the leading cause of ear canal infections as it scratches the ear canal skin and allows bacteria to enter the skin causing an ear canal infection (otitis externa), he noted.

Dr. Carnoil said many patients ask how they should clean the wax from their ears. 'Earwax is made in the outer 1/3 of the ear canal, and it is water- soluble. Therefore, after a shower, most people can get away with just using a washcloth to wipe the wax away from the ear,' he said.

According to NICE guidelines, the ear canal is ‘ self- cleaning’, with excess wax falling out on its own, and that the entrance to the ears can be cleaned with a damp flannel.

Rather than manual syringing, which can cause trauma, NICE recommends ‘ear irrigation’, in which an electronic machine pumps water safely into the ear at a controlled pressure to remove problem wax.

(© Daily Mail, London)