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Cotton swabs are sending thousands of kids to the ER

Feel the need to clean your child's ears? Step away from that cotton swab.
/ Source: TODAY

Feel the need to clean your child’s ears? Step away from that cotton swab.

Despite years of warnings to avoid putting the product into the ear canal, more than 263,000 children in the U.S. had to be treated in emergency rooms for ear injuries related to cotton-tip applicators between 1990 and 2010, a new study published in The Journal of Pediatrics has found. That amounts to about 34 injuries a day.

Almost three-quarters of the cases — 73 percent — involved ear cleaning. About two-thirds of the patients in the study were younger than 8.

"There's this misconception that people need to clean their ears in the home setting and that this is the product to do that with," Dr. Kris Jatana, senior author of the study and a pediatric ear, nose and throat specialist at Nationwide Children’s Hospital, told TODAY.

"The ears themselves are typically self-cleaning... It is risky to use cotton-tip applicators in the ear canal across all age groups, and certainly we are seeing way too many injuries as a result of this practice."

Q-tips, cotton swabs
If you're using cotton swabs to clean your child's ears, you really need to stop! Shutterstock

The most common diagnoses in the ER included the presence of a foreign body — most likely part of the cotton swab stuck the ear canal — and a perforated eardrum, according to the study, which analyzed data in the National Electronic Injury Surveillance System.

"It's difficult for people to gauge how deep they're putting [the swab]," Jatana said. "Sometimes, it just takes a small movement to puncture the ear drum."

Almost all of the patients were treated and released, but delaying treatment for such injuries could lead to hearing loss, dizziness, balance problems and even facial nerve paralysis, the researchers note.

Many cotton swab manufacturers include warning labels that say the products should not to be used in the ear. Otolaryngologists do not recommend using the swabs because they can cause injuries or push the ear wax deeper into the canal, causing it to become trapped. Still, many people continue to use Q-tips and similar products for ear hygiene.

Studies have found 90 percent of people believe ears should be cleaned and say they regularly clean their ears or their children’s ears, according to the American Academy of Otolaryngology—Head and Neck Surgery Foundation. Kids also apparently learn to stick Q-tips into their ears by watching their parents: about 77 percent of the injuries in the study happened when the child was handling the swab himself.

The key message: in most cases, leave that ear wax alone because it is beneficial for the ear. Visible wax on the outer part of the ear can be wiped away with a wet wash cloth, Jatana suggested.

Ear wax cleans, protects, and lubricates the ear canal, though one in 10 children and one in 20 adults have excessive wax buildup, guidelines published in Otolaryngology–Head and Neck Surgery in January note.

Here are the group's do’s and don’ts of ear hygiene:


• Realize ear wax is normal. Ear wax that’s not causing symptoms or blocking the ear canal should be left alone.

• Ask your doctor about common self-help measures if you have excessive wax. These include cerumenolytic drops (a wax softening agent) or ear irrigations — flushing the wax out with a jet of warm water.

• Go to the doctor if you have hearing loss, a feeling of fullness in the ear or ear pain. An ear, nose and throat doctor can remove more stubborn excess wax.


• Overclean your ears: it may irritate the ear canal and cause infection.

• Ignore your symptoms if home remedies don’t work.

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