![]() Comparison of the two active treatments showed that the additional gain associated with softeners followed by irrigation at primary care over softeners followed by self-irrigation was at a cost of 340,000 pounds per QALY. Resuts of the exploratory economic model found that softeners followed by self-irrigation were more likely to be cost-effective than softeners followed by irrigation at primary care (32,130 pounds per QALY) when compared with no treatment. AEs appeared to be minor and of limited extent. On measures of wax clearance Cerumol, sodium bicarbonate, olive oil and water are all more effective than no treatment triethanolamine polypeptide (TP) is better than olive oil wet irrigation is better than dry irrigation sodium bicarbonate drops followed by irrigation by nurse is more effective than sodium bicarbonate drops followed by self-irrigation softening with TP and self-irrigation is more effective than self-irrigation only and endoscopic de-waxing is better than microscopic de-waxing. Participants, outcomes, timing of intervention, follow-up and methodological quality varied between studies. The range of interventions included 16 different softeners, with or without irrigation, and in various different comparisons. Twenty-six clinical trials conducted in primary care (14 studies), secondary care (8 studies) or other care settings (4 studies), met the inclusion criteria for the review - 22 RCTs and 4 CCTs. Outcomes were assessed in terms of benefits to patients and costs incurred, with costs presented by exploratory cost-utility analysis. For the economic evaluation, a deterministic decision tree model was developed to evaluate three options: (1) the use of softeners followed by irrigation in primary care (2) softeners followed by self-irrigation and (3) a 'no treatment' option. Study criteria included: interventions - all methods of earwax removal available and combinations of these methods participants - adults/children presenting requiring earwax removal outcomes - measures of hearing, adequacy of clearance of wax, quality of life, time to recurrence or further treatment, AEs and measures of cost-effectiveness design - randomised controlled trials (RCTs) and controlled clinical trials (CCTs) for clinical effectiveness, cohort studies for AEs and cost-effectiveness, and costing studies for cost-effectiveness. Any differences were resolved by discussion or by a third reviewer. Inclusion criteria were applied to the full text or retrieved papers and data were extracted by two reviewers using data extraction forms developed a priori. Two reviewers screened titles and abstracts for eligibility. To conduct evidence synthesis of the clinical effectiveness and cost-effectiveness of the interventions currently available for softening and/or removing earwax and any adverse events (AEs) associated with the interventions.Įleven electronic resources were searched from inception to November 2008, including: The Cochrane Library MEDLINE (OVID), PREMEDLINE In-Process & Other Non-Indexed Citations (OVID), EMBASE (OVID) and CINAHL. ![]() However, the safety and benefits of the different methods of removal are not known for certain. Current practice for earwax removal generally involves the use of a softening agent, followed by irrigation of the ear if required. ![]() We are fully accredited for practicing wax removal.Build-up of earwax is a common reason for attendance in primary care. This technique is suitable for any adult who requires wax removal and is especially necessary for people who have grommets, perforated eardrums, or people with depressed immune systems or those taking blood thinners. Sometimes if the wax is particularly hard softening may be required first by using eardrops. Micro-suction is a safe and effective way to remove ear wax no water is used, instead, the wax is gently removed using a device similar to a gentle vacuum. ![]() In these cases the wax needs to be removed, and techniques such as using cotton buds (q-tips) or ear candling can push the wax further in or risk injury to the ear. ![]() Some people produce too much ear wax and it can block up the ear canal, and cause temporary changes to the hearing and ear health. It protects the skin in the ear canal and helps in cleaning and lubricating the ear. Ear wax is a normal substance secreted by the ear. ![]()
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