Featured Review: Assessing the effects of ear drops (or sprays) to remove or aid the removal of ear wax in adults and children

Featured Review: Assessing the effects of ear drops (or sprays) to remove or aid the removal of ear wax in adults and children

Which treatment can help resolve wax build up?

Build up of ear wax is common. It can be uncomfortable for the patient and can cause hearing problems. Ear drops have been studied as a potential tool to soften the wax, preventing the need for further treatment such as syringing. This new review, produced by a team from the UK and US as part of Cochrane Ear, Nose and Throat,  looks at which treatment (oil- and water-based drops or sprays) can help resolve wax build up.

The review includes 10 studies, with 624 participants (835 ears). Interventions included:

  • oil-based treatments (triethanolamine polypeptide, almond oil, benzocaine, chlorobutanol);
  • water-based treatments (docusate sodium, carbamide peroxide, phenazone, choline salicylate, urea peroxide, potassium carbonate);
  • other active comparators (e.g. saline or water alone) and no treatment.

Key results: Only one study compared using drops with an active ingredient to not using drops at all. The drops may help increase the proportion of ears cleared of wax from 1 in 20 (if you do nothing) to about 1 in 5 (if you use drops).

The authors did not find any evidence that water-based or oil-based drops were any different to saline or water. However, we also did not find any evidence that water or saline were better than doing nothing.

Adverse (side) effects were not common. Fewer than 30 patients reported any adverse events when using the drops and these were mild (such as slight irritation or pain, or unpleasant smell). No serious side effects were reported by any participant.

Quality of the evidence: For wax clearance, we rated the quality of the evidence as low. For adverse effects we rated the quality of the evidence as low.

Professor Martin Burton, joint Co-ordinating Editor of Cochrane ENT said, “Many people use ear drops when they want to soften or remove wax from their ears.  There’s not much high quality, scientific evidence out there to help people decide which to use.  But what there is, suggests that using any sort of drops is better than nothing.  When it comes to the choice of drops, there are various chemical-containing preparations sold over-the-counter for this purpose.  This study shows that they aren’t necessarily any better than plain or salty water.”

Wednesday, July 25, 2018
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