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Am Fam Physician. 2003;67(4):870-871

Earwax is frequently removed by syringing to relieve symptoms such as tinnitus, vertigo, deafness, and earache. Although 150,000 ear-wax removals are performed every week in the United States, the benefits of the procedure are controversial. In particular, experts disagree on the ability of ear syringing to improve hearing, and some are concerned that the procedure can have adverse effects such as tympanic membrane damage or promotion of infection. Memel and colleagues studied the effect of ear syringing on hearing.

They studied more than 100 patients who attended general practices in an English city to have earwax removed. Patients were randomly assigned to the intervention or control groups. Hearing was tested before and after ear syringing in the intervention patients. Patients in the control group had their hearing tested twice before ear syringing. The audiologist interpreting the tests was not aware of the study group assignment of the patients. An improvement in hearing threshold averaging 10 dB or more across four frequencies was the primary outcome measure.

The patients in the two groups were comparable; more than 70 percent of patients in each group gave hearing problems and blocked ears as their primary complaints. The hearing threshold improved by at least 10 dB in 18 (34 percent) intervention patients but in only one (1.6 percent) patient in the control group. Because several patients did not experience benefit, the difference in average improvement in hearing between the two groups was only 6.9 dB. Patients who did benefit from ear syringing had significant improvement, ranging from 15 to 36 dB. The improvement was especially marked in those who presented with a hearing problem. Hearing improved by 10 dB or more in 41 percent of these patients.

The authors conclude that ear syringing improves the hearing threshold in a substantial proportion of patients, although they could not predict which patients would benefit. Ear syringing appears to be particularly effective in some patients but not effective in others.

editor's note: Ear syringing is a very common procedure in nursing homes—and the patients hate it! I have heard rumors of removing earwax in children by using liquid stool-softening agents but cannot find references or colleagues who have used this method in adults. If anyone knows a better way to remove earwax, please let us know.—A.D.W.

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