Earwax treatment could save NHS time
A new study has shown a self-use bulb syringe
as an effective first-line treatment for earwax. The
inexpensive syringe, available over the counter in the US and in
most European countries, could reduce the need for ear syringing in
primary care.
The study, funded by the Royal College of
General Practitioners (RCGP) and published in the British
Journal of General Practice (BJGP), used an open,
randomised and controlled trial in seven practices in
Hampshire.
237 patients with symptomatic occluding earwax
were divided into two groups. The first group was given ear
drops, a bulb syringe, and instructions on its use. The other
received ear drops, followed by ear irrigation by the GP or
practice nurse. The main outcome measures were symptoms (on a
7-point scale), wax clearance, need for further treatment, and the
acceptability of treatment.
Comparing patients that used the bulb syringe
with conventional irrigation, the change in the mean symptom score
was -0.81 and -1.26 respectively, and regarding the proportion that
needed no further irrigation, 51% and 69% respectively.
Although irrigation was preferred by more patients, most patients
using the bulb syringe would use it again (75% versus 100%) and
were satisfied with treatment (71% versus 99%).
Dr Richard Coppin, who headed the trial, said,
“This study shows that although first-line treatment by irrigation
carried out by a practice nurse is more effective, a third of those
patients will probably have to return a second time for further
irrigation. This compares with half of patients using a bulb
syringe. Based on these rates, a policy of offering bulbs as
an initial alternative to nurse irrigation would result in a
worthwhile reduction in the number of irrigations performed.
“A potential impediment to the implementation
of this in the UK is the current limited availability of bulb
syringes. However, there is no reason why pharmacies and
practices should not be able to order stocks of bulbs for their
patients to use.”
Notes to editors
- Managing earwax in primary care: efficacy of self-treatment
using a bulb syringe was published by Dr R Coppin, Dr D Wicke
and Dr P Little in British Journal of General Practice
(BJGP), p. 44
- The Royal College of General Practitioners is
a network of over 30,000 family doctors working to improve care for
patients. We work to encourage and maintain the highest standards
of general medical practice and act as the voice of GPs on
education, training, research and clinical standards.