Paramedics who arrived to help a young man who had collapsed
one afternoon were totally mystified.
Only 31 years old, he had, without any warning, started
having seizures and violent headaches. He was also forgetting people’s names —
and then he passed out.
After being taken to A&E at Coventry Hospital, he
was quickly sent for a brain scan which solved the riddle: two pus-filled
abscesses on the lining of his brain.
The cause? A piece of cotton bud found buried deep inside
his left ear.
The bud had led to necrotising otitis externa, a bacterial
infection that starts in the ear canal before spreading to the skull, where it
eats through the bone.
Facial nerves can also be affected, causing a stroke-like
droop. Also known as malignant otitis externa, it is usually seen in the
elderly, and others with a compromised immune system. While rare, it can be
fatal.
The unnamed man, whose case was detailed in the journal BMJ
Case Reports in March, did not know how long the cotton bud tip had been there.
But he told his doctors he’d suffered ‘intermittent left ear pain and hearing
loss’ for the past five years.
The cotton tip had to be removed under anaesthetic. The
patient made a full recovery — but only after eight weeks of intravenous
antibiotics. ‘Most importantly,’ wrote his doctors, ‘he is no longer using
cotton buds’.
It’s an extreme example, but cotton buds can cause a range
of problems, including infections, impacted earwax, perforated ear drums and
tinnitus.
The NHS, GPs and even the manufacturers warn against digging
inside the ear with cotton buds — but millions still do it.
Nearly two-thirds of us, in fact, according to a YouGov
survey of 1,730 people in February — and we get through nearly two billion of
the things a year.
‘A lot of people seem to think earwax is dirty, but it is
natural and important,’ says Dr Roger Henderson, a GP from Dumfries, with more
than 30 years experience of treating ear problems.
‘I’ve seen patients put pencils and even hair clips down
their ear canal to clean it. It just damages the lining, and can be dangerous.’
Earwax, or cerumen, acts as a filter, trapping dust and
dirt. It also repels water, lubricates the delicate ear lining and, being
slightly acidic, kills bacteria.
‘In most cases, cotton buds simply ram wax further down the
ear,’ says Dr Henderson. The wax then becomes impacted, hardening and blocking
the ear, causing hearing problems. Poking around inside the ear can also
perforate the ear drum, leading to potentially permanent hearing loss.
And, as the man in Coventry found, infections are also a
risk.
Vik Veer, a consultant surgeon at the Royal National Throat,
Nose and Ear Hospital in London, sees people with infections ‘on a daily
basis’. ‘In their most extreme form, these ear canal infections may progress to
malignant otitis externa, particularly in the elderly or in diabetics,’ he
says. ‘We’ve always had one or two such patients on the ward.’
So, how should you clean your ears? The short answer is,
don’t.
‘That’s how cavemen cleaned their ears — they just left
them,’ says Mr Veer.
The skin lining the ear is constantly growing outwards from
the ear drum and earwax is transported along it. When it reaches the outer ear,
it falls out naturally.
However, if you use cotton buds, it is likely you have
damaged the lining, upsetting the delicate ‘conveyor belt’ system and wax will
be building up.
Mr Veer advises using sodium bicarbonate drops — available
from chemists — to dissolve stubborn wax. Use once or twice a day, going down
to once a week, for between two and five months while the lining heals.
Olive oil drops soften wax, rather than melting it, but are
useful ahead of having wax professionally removed. If you have been using
cotton buds regularly, to protect against infections until the lining heals, Mr
Veer recommends using EarCalm, an antibacterial spray, at least once a day.
As we age, wax becomes harder and drier, which can hinder
its natural movement out of the ear.
Signs of wax build-up include hearing loss, a feeling of
fullness in the ear and a ringing or crackling sound.
If you think wax is blocking your ears, the NHS recommends
seeking a pharmacist’s advice, followed by seeing a practice nurse who can
perform microsuction, in which a miniature vacuum sucks out the wax. This is
also available privately, with providers charging around £35 per ear.
Dr Henderson, a spokesman for Earex ear drops, says that
home syringing should be avoided. ‘If used incorrectly, there’s a risk you
could perforate the ear drum.’
And ‘ear candling’, in which a lit, hollow candle is
inserted into the ear in the belief it draws out the wax, ‘is a really bad
idea’, says Mr Veer. Apart from the danger of burns, studies show it can
deposit candle wax in the ear.
‘Please don’t use candles for earwax,’ says Mr Veer. ‘Use them
for romance and power cuts.’
(Daily Mail)
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