BACKGROUND AND OBJECTIVE: Cerumen (or earwax) impaction is usually asymptomatic, although in some cases, it leads to symptoms such as hearing loss and discomfort in the ear. Various approaches with different side-effects have been applied for the removal of earwax buildup. In this study, we aimed to evaluate the prevalence of external otitis after suction clearance. We also investigated the prevention of possible infections.

METHODS: This clinical trial (IRCT:201104176208N1) was conducted on 184 patients, diagnosed with cerumen impaction, referring to the Ear, Nose and Throat Clinic of Ayatollah Ruhani Hospital in Babol city, Iran. Patients were examined at the time of admission and earwax was removed, using microscope-guided suction clearance. The patients were randomly divided in two groups. The first group (87 patients) received no special treatments and the second group (97 patients) underwent a prophylactic treatment, which consisted of acidifying the ear with 2% Boericke alcohol and application of miconazole ointment by a swab. Two weeks after the treatment, the patients were re-examined in terms of infections. Also, part of the earwax was cultured in an appropriate medium, and the type or species of microorganisms was determined via conventional techniques.

FINDINGS: External otitis was reported in none of the patients in the two groups. The most common bacteria in the cerumen samples were Bacillus (19.58%) and coagulase-negative Staphylococcus (15.22%), respectively. Also, the most common cultivated fungi in cerumen samples were Aspergillus niger (21.2%) and Penicillium (13.04%), respectively.

CONCLUSION: The results showed that the use of Boericke alcohol and miconazole ointment does not lead to any side-effects for the patients. Therefore, this preventive method is recommended to general practitioners with less experience in differentiating pure cerumen from cerumen with fungal infections.