I’ve seen people employ strange methods to clean their
ears. Words of advice: don’t clean your
ears with foreign objects or ingenuous instruments such as bobby pins, crochet
needles, bamboo skewers, wire clothes hangers, not even those cotton swabs
known as Q-tips. I’ve seen patients
traumatize their ears using these and sundry other devices. Many people ignore this advice, even coming
from an ENT doctor, insisting they “won’t go too deep,” or reassuring me that
“I’m very careful, I know my body, doc.”
But alas, the unexpected occurs, and these same people can be found in
their doctor’s office, referred to an ENT specialist, or even in the E.R. due
to excruciating pain they’ve inflicted upon themselves or causing a terrible
ear infection as a result.
How can this be? The
ear is a very delicate structure. For
instance, take the ear drum (tympanic membrane). You probably know that the ear drum is a
paper-thin, nearly translucent, membrane overlying tiny bones of hearing. It doesn’t take much to damage that ear
drum. The ear canal leading from the ear
drum to the outside also is quite fragile, where the inner (medial) two-thirds
is virtually skin on bone. As the figure
above demonstrates, even a blunt instrument such as a cotton swab can hit the
canal, which can easily disrupt the skin, creating a nidus for infection. Bacteria invaded into this disrupted area,
infecting the skin and soft tissue further inward and outward to involve the
outer ear (auricle) and areas around it, such as the face, head and neck.
I’ve seen patients with swollen and red ears, sometimes
needing hospitalization and intravenous (i.v.) antibiotics.
A few words about “candling” the ears to remove wax. Don’t do it.
It doesn’t work.
How should you clean your ears?
One of the simplest methods is via a gentle irrigation. I usually recommend a 1:1 mix of white
vinegar (which is also known as acetic acid) and isopropyl (rubbing)
alcohol. Apply this into the ear with a
dropper—do not use an object such as a cotton swab for the reasons just
explained—and fill the canal with this solution. If you don’t have a dropper, use a cotton
ball saturated in the solution and use it as a make-shift dropper by squeezing
it into the ear. Massage the solution
into the ear by compressing the tragus—the flap of skin and cartilage that lies
in front of the entrance into the ear canal.
This allows the solution to mix around to clean the ear. Alternatively, you can use a small syringe to
gently irrigate the ear.
Caution: make sure the solution is close to body
temperature. Otherwise if too cold, you
could experience a caloric effect which then caused vertigo or dizziness which
is a highly unpleasant experience, so I was told.
People have irrigated their ears with warm water or rinsed
the ear under the shower. This is an
acceptable method, but avoid drying the ear with a cotton swab. If you feel water trapped in the ear, use the
solution above just isopropyl alcohol by itself. Alcohol evaporates at a lower temperature
than water, and since it easily mixes with water, it helps to remove water and
effectively dry the ear. It is paramount
to remove any excess water, for this too can cause otitis
externa or “swimmer’s ear.”
Another method is the use of hydrogen peroxide. This is helpful for firm or very dry ear
wax. If you are to use this method, fill
the ear canal with the peroxide and allow it to effervesce for about 15
minutes. The by-product of hydrogen
peroxide is water, and thus you need to remove the water by the methods just
explained above.
There you have it: the do’s and don’ts of ear cleaning. If you simply must ignore this advice and
clean your ears with strange elongated instruments and injure yourself, please
visit your common-sense counsellor.
©Randall S. Fong, M.D.
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