Abstract
Objective : The ear irritations suffered by hearing aid (HA) users are yet to be related to the clinical state of canal. We undertook this study to examine the nature of debris and the microbial flora of ears of hearing aid users, as well as evaluate the determinant factors of ear irritation in this population. Methods : An observational clinical study was carried out involving 32 unilateral hearing aid users recruited from ENT clinic of a tertiary referral center. Each subject underwent otoscopic assessment of canal debris and microbial analysis of swab cultures taken from the hearing aid-wearing ear and contralateral normal ear without hearing aid. Results : Canal debris [wax (28%), fungal deposits (19%), bacteria exudates (13%)]. as well as microorganisms were identified in significant number of ears with hearing aids than ears without hearing aid (P = 0.003 and P = 0.006 respectively). Coagulase-negative staphylococci were the commonest identified bacteria. Others were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus species. Intolerable irritations of hearing aid wearing ears were significantly associated with bacterial and fungal otitis externa, and ear discharge (P = 0.005, 0.02, 0.03 respectively). Conclusions : This study demonstrates that using hearing aid alters the ear canal flora; increases risk of both fungal and bacterial otitis externa, as well as encourage wax debris formation, with resultant ear irritations. To ensure compliance their ears should periodically be attended to, by de-waxing or given topical antimicrobial agents where indicated.
Highlights
Hearing aid (HA) users often present to otolaryngologist with complaints of constant irritations within the ear canals on account of either allergic contact dermatitis from the earmolds which connect the HA to the ear canal,[1,2] or bacterial/ fungal otitis externa,[3,4] or wax impaction
The growths of these microorganisms are yet to be related to the clinical state of canal with HA with and whether these organisms result in actual infection of the external auditory canals
Wearing HA seems to modify the microbial flora of the ear canal
Summary
Hearing aid (HA) users often present to otolaryngologist with complaints of constant irritations within the ear canals on account of either allergic contact dermatitis from the earmolds which connect the HA to the ear canal,[1,2] or bacterial/ fungal otitis externa,[3,4] or wax impaction. Some other users discontinue the use of the hearing aids on account of the irritations from debris accumulation in the canal. The most challenging scenario is with persistent bacteria/ fungal otitis externa where the otolaryngologists sometimes consider fitting of the aids via more invasive alternative routes such as middle ear hearing implants.[5,6,7] A wide range of contaminating bacteria and fungi growing on hearing aid surfaces as well as ear canals of HA users has been documented.[3,4,8,9] the growths of these microorganisms are yet to be related to the clinical state of canal with HA with and whether these organisms result in actual infection of the external auditory canals
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