Paediatric presentation of ear cleaning in a West African country

Abstract

Background: Ear cleaning is very common medico-social habit among children worldwide. This study aimed at determining the prevalence, socio-demographic features, clinical presentation, associated complications and management of paediatric ear cleaning in a tertiary hospital in a West African country. Methods: This was a prospective cross-sectional hospital-based study which was carried out in Ear, Nose and Throat department of Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria, over a period of 6 months, between July and December 2017. Consent was obtained from the patients/parents/guardian. The instrument of data collection was a pretested interviewer-assisted questionnaire. Data obtained was collated and analysed using SPSS version 16.0. Results: Prevalence of ear cleaning in paediatric age group was 91.1%. Males were more affected and accounted for 53.4%. The most common reason for ear cleaning was due to personal hygiene. Ear cleaning was done in 57.1% of the children by their mother. Bilateral ear cleaning was noted in 45.3% of patients, 31.6% in the right ear and 23.1% in the left ear. Majority (65.5%) of patients believed that ear cleaning were beneficial. The commonly used object in ear cleaning were cotton bud, finger, sticks and writing material in 35.2%, 18.6%, 13.8% and 13.4%, respectively. Common clinical features among the patients were dirty/earwax, otalgia and itching in 33.6%, 30.8% and 25.9%, respectively. Short time (acute) ear cleaning in 57.9% was more common than long time (chronic) ear cleaning in 42.1%. The frequency of ear cleaning was done on a daily basis in 55.9% of patients, in 21.5% of patients weekly. In 12.6% of patients monthly while 10.1% of patients used to clean their ears occasionally. Major clinical diagnoses of ear cleaning in children were 26.3% personal hygiene, 19.4% allergy and 17.8% earwax. Common complications were external auditory canal injury in 32.4%, impacted foreign body in 21.5% and traumatic perforated tympanic membrane in 6.5%. About 42.9% of our patient obtained information about cleaning of ear from family, 29.6 % from neighbourhood while 27. 5% did not obtained information from anywhere. Treatment included conservative/medical treatment in 60.7%, foreign body removal in 21.5% and impacted earwax removal in 17.8%. Conclusions: Ear cleaning is a common otological habit among children. Personal hygiene was the most common reason for ear cleaning and with cotton bud been being the most common object used. The habit is associated with avoidable complications. Health education and treatment of underlying causes is paramount to reduce this habit.