Every once in a while, children and adults feel a lot of pressure or pain in their ears, and thick wax clogs their ear canal and needs to be removed. Doctors can try to scoop or rinse it out, but many over-the-counter drops can soften it up. But which one works best? This was reviewed by the Cochrane group, the world’s leading reviewer of evidence-based medicine. Their perhaps unsurprising finding was that none of the major drops worked much better than the other; even water-based or saline-based drops worked. However, they weren’t too happy with the overall quality of the studies they reviewed in their literature search. Here’s their “plain language summary” from their review (Ear drops for the removal of ear wax):
Using ear drops to remove impacted ear wax is better than no treatment, but no particular sort of drops can be recommended over any other. Impacted ear wax is one of the most common reasons that people visit their general practitioners (family doctors) with ear problems, as it can cause reduced hearing, discomfort, and sometimes pain and dizziness. Ear drops (either oil- or water-based) are often prescribed to clear the wax or to aid subsequent ear syringing if necessary. The review of trials found that ear drops (of any sort) can help to remove ear wax, but that water and saline drops appear to be as good as more costly commercial products. The quality of the trials was generally low, however, and more research is needed.
The Bottom Line?
You should certainly try some type of wax softener before coming to the doctor, who would probably prescribe something just as effective as an OTC product. For more information, you can read this patient handout from American Family Physician.
By the way, you should never routinely use cotton swabs to clean your ears! There’s no need at all to routinely clean your ear canal, as mother nature does it just fine. I see many patients who have outer ear infections, and most have a story of routinely cleaning their ears with something, usually Q-tips. Remember that earwax is normal and protective; daily messing around in your ear canal sets you up for infections as well as risks of puncturing your eardrum.
Air pollution is a growing problem in many urban areas. Many people may not realize that over the last five years there is a lot of new research proving more serious health effects at lower levels than we had previously thought. The danger is especially acute in children, whose lungs are not fully formed and therefore more vulnerable. Now, there’s a great new review as well as
Food allergies in children, as a diagnosis, are more common than before. But are we over-diagnosing? The main issue is that the tests we perform, especially the blood tests for allergens, may show a positive “in vitro” allergy but “in vivo”, AKA in real life, there may not be a clinically significant allergy.
It’s a bit, um, difficult to make air pollution a cool subject for kids. Even my recent slide show on air pollution left a few high-schoolers eyes glazed. Fortunately, I spread out a couple fun internet games to perk up the group. Fun and educational! Throw in free and you have an instant hour or two of kid-distractions..jpg?resize=101%2C134)
People may not realize that there have been amazing advances in technology that can help deaf children hear again. It’s called a cochlear implant, a surgical implant that amplifies sound waves directly into a child’s brain — and allows them to hear again.
