Self-Ear Cleaning Practices and the Associated Risks: A Systematic Review

Abstract

BACKGROUND: Naturally the ear produces soft wax from the sebaceous and ceruminous gland. This is what is referred to as earwax. This wax is important for protection of the ear by trapping dust and other foreign particles that could damage the eardrum. It also has some antibacterial properties. Jaw movements, like during chewing, moves the old earwax from inside the ear canal to the outside and finally flakes off. Build-up of this wax in the ear causes hearing loss, pain in the ear, irritation, dizziness and ringing in the ears. Self-ear cleaning refers to self-insertion of objects into the ear canal, with an attempt to remove the wax to get rid of these symptoms. It is a common practice amongst many individuals. Potentially, this rids the ear of its protective defences in addition to posing a risk of ear related injuries. This review paper aims to determine the prevalence of self-ear cleaning, the common methods used and the complications associated with this practice. 
 
 METHODS: Electronic retrieval of articles for review was done from PubMed, Google and Google scholar with key-ward – self-ear cleaning, ear-wax, cerumen. Many articles were retrieved but only a few were about self-ear cleaning and only seven could be included in this review. The inclusion criteria included: article published in English language; study carried between 2005 and 2020 inclusive; article discussing materials used and complications associated with self-ear cleaning. Articles older than 15 years or published in languages other than English were excluded.
 
 RESULTS: On average the prevalence of self-ear cleaning amongst all studies was 76.6%. The commonest method used for ear cleaning was cotton buds with an average of 69.6%. Wax/dirt removal was the commonest reason for engaging in this practice. Several complications arising from this practice included perforation of eardrum, retained foreign body and otitis externa.
 
 CONCLUSION: In addition to ridding the ear of its natural protection, self-ear cleaning is associated with a risk of injury to the ear drum and retention of foreign bodies. Community education to avoid this practice is therefore of paramount importance. Trained health care providers should be consulted whenever someone has a problem related to hearing or any other symptoms.

Knowledge, Attitudes, and Practices of Self-ear Cleaning in Makkah Region, Cross-sectional Study

“…High prevalence was also noted in studies conducted in Saudi Arabia (75%) [12], Nigeria (80%) [6], Malaysia (92%) [13] and Bhutan (92.15%) [14]. Healthcare workers also did not have adequate knowledge and most of them perform matching practice [15,16]. It is as high as 94% in a study by Oladeji et al that was conducted on health workers in a tertiary hospital, which raised concerns considering their role in public awareness [1].…”

Searching for the Holy Grail among ear drops

“…Concomitantly, the innate self-cleaning mechanism of the ear engenders the entrapment and subsequent expulsion of particulate matter, including dust and dirt, along a medial to lateral axis within the ear canal. This process is facilitated by the combined actions of epithelial migration and movements of the jaw 5,6 .…”

Self-ear cleaning practice and the associated ear-related symptoms and injuries among medical students

“…The attitude, awareness and knowledge of the public regarding health hazards and complications of self-ear cleaning are very poor, as there is a common belief that it is beneficial (Afolabi et al, 2009). Many studies have reported poor knowledge regarding self-ear cleaning worldwide (Alateeq et al, 2018;Ghauth et al, 2018;Lukolo et al, 2021;Olajide et al, 2019;Tobih et al, 2021). A study conducted in the Makkah region on a young population demonstrated that 80% of participants had poor knowledge and 60% of them would not consult a doctor if they experienced hearing difficulties (Haji et al, 2021).…”