Comparison of Three Different Ceruminolytic agents (Soda-Bicarbonate, Almond Oil & Normal Saline) with Respect to their Efficacy

Abstract

Objective: To compare the efficacy of three ceruminolytic agents for cerumen impaction with respect to its ease of 
complete removal via suctioning or probe. 
Study Design: A comparative prospective study. 
Place and duration of Study: This study was conducted carried out at the outpatient department of ENT, Abbasi 
Shaheed hospital, Karachi from November 2010 to March 2011.  
Patients and Methods: A comparative prospective study of 75 adult patients with cerumen impaction in either or 
both of the ears carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi. The study was 
done after taking the consent of the patients. All the adult patients of age 18 years or greater, of either sex with the 
symptoms in the ear(s) because of cerumen which was hard/dry and difficult to remove were included in the study. 
Those of age less than 18 years and not having any symptomatology because of the cerumen or with soft wax which 
was easy to clean were not included in the study. The study was carried out from November 2010 till March 2011. 
The patients with problematic, difficult to remove cerumen or cerumen impaction with symptoms were divided in to 
three groups: Group A, Group B and Group C; all having equal number of cases that is 25 each. In group A they 
were given soda-bicarbonate in glycerin based ear drops; in group B almond oil and group C the normal saline for 
instillation in ear. The doses and timings for drops were equal in all the group and it was 3 drops in the affected ear 
every 6-hourly for 1-week. They were councilled that the dose should not be missed and they have to lay down for 5 
minutes so that drops are absorbed and does not come out of the ear. After one week they were called in the OPD, 
their ear(s) were assessed with respect to the cerumen softening and ease of removal, either via probe or suctioning, 
was compared with the completeness of removal of impacted cerumen for the three groups. 
Result: Ease and completeness of cerumen removal was 80% in group A, followed by 60% for group C and 20% for 
group B.  
Conclusion: We found soda-glycerin to be superior to almond oil and normal saline as ceruminolytic agent.