Abstract
A prospective study was done to access the efficacy of ceruminolytic agents, i.e 2% paradichlorobenzene, 10% sodium bicarbonate, 2.5% acetic acid and normal saline. All score 4 hard impacted ear wax cases in the adult population (>20 years) were accrued for the assessment of the relative efficacy. Upon analyzing the comparative efficacy of four ceruminolytic agents, by taking into consideration three parameters (post) ceruminolytic cerumen score, attempts of syringing required to extrude the cerumen mass, post-ceruminolytic use and appearance of the removed cerumen mass. 2% paradichlorobenzene emerged as the most superior ceruminolytic, closely followed by 10% sodium bicarbonate. 2.5% acetic acid fared moderately while normal saline emerged as the least efficacious ceruminolytic agent.
Keywords: Ceruminolytic agents, 2% paradichlorobenzene, Impacted wax, Cerumen score, 10% Sodium bicarbonate, Acetic acid
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References
- 1.Freeman Impacted cerumen: How to safely remove ear wax in an office visit. Geriatrics. 1995;50:52–53. [PubMed] [Google Scholar]
- 2.Crandwell, Roeser Incidence of excessive impacted cerumen in individuals with mental retardation: A longitudinal investigation. AMJ Ment Retard. 1993;97:568–574. [PubMed] [Google Scholar]
- 3.Zikk, Rapoport, Himelfarb Invasive external otitis after removal of impacted cerumen by irrigation. N Eng J Med. 1991;325:969–970. doi: 10.1056/NEJM199109263251320. [DOI] [PubMed] [Google Scholar]
- 4.Lyndon, Roy, Grillage A comparison of the efficacy of two ear drop preparations (Audax & Earex) in the softening and removal of impacted earwax. Curr Med Res Opin. 1992;13:21–25. doi: 10.1185/03007999209115218. [DOI] [PubMed] [Google Scholar]
- 5.Grau (1705) Dissertatio Medica Physiologica De Cerumine. Jena
- 6.Toynbee J. Diseases of the Ear. Philadelphia: Blanchard and Lea; 1860. pp. 82–87. [Google Scholar]
- 7.Politzer A. Diseases of the Ear and Adjacent organs, Henry C. Philadelphia: Lea’s Son and Co; 1883. pp. 580–583. [Google Scholar]
- 8.Roeser, Ballachanda Physiology, pathophysiology and anthropology/epidemiology of human ear canal secretions. J. American Acad Audiol. 1997;8(6):391–400. [PubMed] [Google Scholar]
- 9.Colin Kidd (2006) The forging of races: Race and scripture in the Protestant Atlantic World, 1600–2000: Cambridge University Press. pp 4
- 10.Carr S. Ceruminolytic efficacy in adults versus children. J Otolaryngol. 2001;30:154–156. doi: 10.2310/7070.2001.20001. [DOI] [PubMed] [Google Scholar]
- 11.Cipriani, Taborelli, Gaddia Production rate and composition of cerumen. Influence of sex and season. Laryngoscope. 1990;100:275–276. doi: 10.1288/00005537-199003000-00012. [DOI] [PubMed] [Google Scholar]
- 12.Jacobsen Age related changes in sebaceous wax ester seretion rates in men and women. J Invest Dermatology. 1985;85:483. doi: 10.1111/1523-1747.ep12277224. [DOI] [PubMed] [Google Scholar]
- 13.Chiang, Lowry, Senturia Microchemical studies on normal cerumen. I. The lipid and protein content of normal cerumen as affected by age and sex. Laryngoscope. 1955;65:927. doi: 10.1288/00005537-195510000-00002. [DOI] [PubMed] [Google Scholar]
- 14.Matsunaga, Itoh, Suzuki, Sugimo Incidence and inheritance of the ear wax types. Sapporo Med J. 1954;6:368. [Google Scholar]
- 15.Fahmy, Whitefield Multicentre clinical trial of Exterol as a cerumenolytic. Br J Clin Pract. 1982;36:197–204. [PubMed] [Google Scholar]
- 16.Keane, Wilson, McGrane Use of solvents to disperse ear wax. Br J Clin Pract. 1995;49:71–72. [PubMed] [Google Scholar]
- 17.Dummer, Sutherland, Murray A single -blind, randomised study to compare the efficacy of two ear drop preparations (’Audax’ and Cerumol) in the softening of ear wax. Curr Med Res Opin. 1992;13:26–30. doi: 10.1185/03007999209115219. [DOI] [PubMed] [Google Scholar]
- 18.Fraser The efficacy of wax solvents: in vitro studies and a clinical trial. J Laryngol Otol. 1970;84:1055–1064. doi: 10.1017/S0022215100072856. [DOI] [PubMed] [Google Scholar]
- 19.Mehta An in vitro comparison of the disintegration of human earwax by five cerumenolytics commonly used in general practice. Br J Clin Pract. 1985;39:200–203. [PubMed] [Google Scholar]
- 20.Robinson, Hawke The efficacy of ceruminolytics: everything old is new again. J Otolaryngol. 1989;18:263–267. [PubMed] [Google Scholar]
- 21.Bellini, Terry, Lewis An evaluation of common ceruminolytic agents: an in vitro study. Clin Otolaryngol. 1989;14:23–25. doi: 10.1111/j.1365-2273.1989.tb00332.x. [DOI] [PubMed] [Google Scholar]
- 22.Carr S. Ceruminolytic efficacy in adults versus children. J Otolaryngol. 2001;30:154–156. doi: 10.2310/7070.2001.20001. [DOI] [PubMed] [Google Scholar]
- 23.Hall, Colman . Diseases of the Throat, Nose and Ear. 11th ed. London: Churchill Livingstone; 1975. Diseases of the external ear; pp. 244–245. [Google Scholar]
- 24.Ballantyne, Groves . A Synopsis of Otolaryngology. 3rd ed. Bristol: John Wright & Sons Ltd; 1978. Miscellaneous conditions of the ear; pp. 90–91. [Google Scholar]
- 25.Mawson, Ludman . Diseases of the Ear. 4th ed. Chicago: Edward Arnold; 1979. Diseases due to trauma or physical agents; pp. 240–241. [Google Scholar]
- 26.Maran . Otorhinolaryngology. Baltimore: University Park Press; 1983. Description of specific diseases of the ear; pp. 21–22. [Google Scholar]
- 27.Hinchcliffe British Medical Journal. 1955;2:722. doi: 10.1136/bmj.2.4941.722. [DOI] [PMC free article] [PubMed] [Google Scholar]