ear wax!

higher incidence in people with learning disability https://onlinelibrary.wiley.com/doi/full/10.1111/j.1468-3156.2005.00351.x?saml_referrer#b9%20#b10

ear candling – no evidence it works/ some evidence it makes worse by depositing candle wax inside the ear
survey of ENT drs – lots reported seeing injuries from use esp burns
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231549/

self ear irrigation devices – bulb syringes used in other european countries — paper concluded that a bulb that was effective and useful
of course need to be pretty sure it’s ear wax that’s the problem – exclusion criteria

pain/previous perforation/smelly discharge/concerns about infection /some types previous ear surgery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2148238/ – great study 2008 Hampshire general practices RCT compared patients using sodium bicarbonate drops for a few days to soften then either irrigation by nurse or bulb syringing at home by patient given an instruction sheet
most satisfied – but about half bulb needed irrigation as well, compared with a third for re irrigation

Click to access Blocked-ears-wax-self-care-guidelines-for-patients.pdf

NICE don’t make an individual recommendation for home bulb syringe use but do link to information sources on how to use them
https://cks.nice.org.uk/topics/earwax/management/management/

Click to access Blocked-ears-wax-self-care-guidelines-for-patients.pdf

written ministerial statement – sept 20 – say it’s an enhanced service and needs to be commissioned – in other words has to be paid for “said ”
https://www.bbc.co.uk/news/uk-politics-54296737#:~:text=People%20suffering%20from%20a%20build,a%20government%20minister%20has%20confirmed.&text=The%20National%20Institute%20for%20Clinical,electronic%20irrigators%20or%20suction%20devices.

systematic review into cost effectiveness – 2011 – The study found limited good-quality evidence, which makes it difficult to differentiate between the various methods for removing ear wax. Although the study was able to show that softeners have an effect in clearing earwax in their own right and as precursors to irrigation, it remains uncertain which specific softeners are superior.

 https://onlinelibrary.wiley.com/doi/10.1111/coa.13692 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177138/#!po=2.94118