The highest rate of emergency department visits for ear injuries
from cotton swabs was in children up to age 3, the researchers
found.
"It highlights the misconception that adults and children need to
clean the ear canal in the home setting," said senior author Dr.
Kris Jatana, a pediatric ear, nose and throat surgeon at Nationwide
Children's Hospital in Columbus, Ohio. "While cotton-tipped
applicators may seem harmless, there are certainly a lot of
potential risks to using them to clean the ears."
Jatana and colleagues write in the Journal of Pediatrics that
cotton-tipped swabs were created in the 1920s to clean babies' ears,
but reports of ear injuries eventually came to light.
"The injuries can range from minor to severe," Jatana told Reuters
Health.
The researchers analyzed data from the National Electronic Injury
Surveillance System, which contains nationally representative data
from U.S. emergency departments, to assess the extent of ear
injuries in children due to cotton-tipped swabs.
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They estimate that overall, 263,338 children under age 18 were seen
at U.S. emergency departments between 1990 and 2010 for ear injuries
tied to the use of these products.
The yearly number of visits for this reason rose from 9,794 in 1990
to 17,449 in 2001, but then declined to 12,911 in 2010.
About 40 percent of emergency visits were due to a feeling of
something stuck in the children's ears. About 35 percent of visits
were due to bleeding, and about 17 percent were due to ear pain.
After examination, about 30 percent of children were diagnosed with
a foreign body in their ears. A quarter of children were diagnosed
with broken eardrums, technically known as tympanic membrane
perforations. About 23 percent were diagnosed with soft tissue
injuries to the ear.
Almost all the children were treated in the emergency department and
released without needing to be hospitalized, the researchers found.
About 40 percent of injuries occurred among children up to age 3,
and about 67 percent occurred among those under age 8.
In nearly two-thirds of the cases, the researchers had information
on where the injury occurred - and almost all happened at home.
When they were able to document the cause of the injury, the
majority were due to cleaning.
"We’ve learned over the years that it’s not a safe practice to
insert this product into ears," said Jatana.
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Even ear, nose and throat doctors wouldn't use cotton-tipped swabs
to clean out earwax, said Dr. Cuneyt Alper, a pediatric ear, nose
and throat specialist at the Children's Hospital of Pittsburgh of
UPMC.
"We use different instruments ourselves," said Alper, who was not
involved with the new research.
Serious injuries to the ear canal or the eardrum are rare, according
to Dr. Alyssa Hackett, a pediatric ear, nose and throat specialist
with New York Eye and Ear Infirmary of Mount Sinai in New York.
"More commonly, the wax is pushed deep into the ear canal instead of
removed by the cotton swab which can cause a temporary hearing loss
similar to the feeling of having an ear plug in the ear," said
Hackett, who also wasn't involved with the new research.
She added in an email to Reuters Health that ear wax deep in a
child's ear can be difficult and painful for a doctor to remove. It
may also make diagnosing an ear infection difficult or impossible.
Instead, Alper recommends using a cotton ball to remove visible wax
from the entrance to a child's ear.
Parents should "go after the wax that they see," he told Reuters
health. "Ear canals are self cleaning - typically - unless the wax
is pushed in."
Jatana said using soapy water and a washcloth at bath time should
also do a satisfactory job.
SOURCE: http://bit.ly/2qYBDoX The Journal of Pediatrics, online May
1, 2017.
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