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Ear candles: A triumph of ignorance over science
Abstract
Ear candles are hollow tubes coated in wax which are inserted into patients' ears and then lit at the far end. The procedure is used as a complementary therapy for a wide range of conditions. A critical assessment of the evidence shows that its mode of action is implausible and demonstrably wrong. There are no data to suggest that it is effective for any condition. Furthermore, ear candles have been associated with ear injuries. The inescapable conclusion is that ear candles do more harm than good. Their use should be discouraged.
... However, in terms of efficacy, there is no evidence that shows that facial candling helps in reducing AR, similar to the ear candling treatment that is also traditionally used to relieve sinus pressure and pain. [13] In fact, scientifically, there is no link between so called dust mites and AR or sinus infection. Moreover, there is no scientific proof encouraging the use of facial candling for such conditions, and the research on this topic is limited. ...
... Usually after treatment, the patient realized that there was whitish powder on their face, and most of the practitioners insisted that the powder was evidence of facial candling reducing symptoms of "resdung." [13] To the authors' best knowledge, no documented literature has been reported on the use of facial candling or its effect on AR. Therefore, we conducted this exploratory qualitative study to describe the facial candling treatment from the perspective of people diagnosed with AR and who had tried this treatment. ...
Aims
Facial candling is one of the traditional treatments that is claimed to be able to help in curing or reducing various allergy and inflammation conditions such as allergic rhinitis. We aimed to explore the perceptions of participants with allergic rhinitis toward their disease conditions and facial candling treatment.
Materials and Methods
The study used a qualitative exploratory design, comprising 12 in-depth interviews. A semi-structured topic guide was used to explore all relevant aspects of the topic, which were audio recorded, transcribed verbatim. All the interviews were conducted in a few beauty salons in purposively selected city areas in the state of Kedah, Malaysia.
Results
Of the 12 patients, seven (58%) reported a positive experience of facial candling treatment, with improvement in the condition of their allergic rhinitis. Specific themes about the experience of facial candling treatment that were identified within the transcript data included knowledge about facial candling, options for disease treatment, effectiveness of facial candling, sources of information, comparison, application of treatment, treatment budget, and safety. The major strength lies in the fact that reasons for using facial candling were uncovered from the perspectives of people with allergic rhinitis through the in-depth interviews.
Conclusions
The motives of these participants for using facial candling are mainly due to cultural influence and its low cost of treatment. There were mixed responses from the participants about the usefulness of facial candling. Most of the respondents had not assessed the safety of prolonged use of facial candling and regarded it as a safe procedure as this has been practiced for generations.
... A fumaça e o calor direcionados ao canal do ouvido promove vasodilatação e mobilização do muco no ouvido interno, narina e garganta, além de promover alinhamento, harmonização e centralização de pensamentos, emoções e sentimentos (Lima Junior, 2017), ajudando o corpo a se autorregular (Lima e Pacheco, 2019). Entretanto, Ernst (2004) afirmou que não existem dados que apoiem essa eficácia para qualquer condição. ...
Objetivou-se com esse estudo avaliar o efeito da terapia do cone de ouvido em cães para o controle do medo e ansiedade, especificamente sobre aspectos comportamentais e parâmetros clínicos. Assim, 13 cães com comportamento associado ao medo e ansiedade foram submetidos a sessões de aplicação de terapia do cone de ouvido, que ocorreu semanalmente, durante quatro semanas. A cada sessão, os cães foram avaliados clinicamente. Durante a anamnese, os tutores responderam um questionário sobre a frequência e intensidade do comportamento indesejado associado ao medo e ansiedade apresentados pelos cães durante a semana anterior à sessão. Em seguida, realizou-se exame físico completo dos cães e os parâmetros clínicos foram mensurados antes da aplicação da terapia (M1), e imediatamente após a sessão (M2). Tanto nos comportamentos mais frequentes, presentes ?60% dos cães (tremor, vocalização excessiva, comportamento autodestrutivo e agressividade), quanto nos menos frequentes (salivação excessiva, urinação e defecação em momentos e locais inadequados e comportamento destrutivo) foram observadas reduções em frequência e/ou intensidade. As frequências cardíaca e respiratória apresentaram redução entre os momentos, enquanto os outros parâmetros variam pouco ou não variaram, estando dentro dos limites normais para a espécie canina. A terapia do cone de ouvido mostrou-se satisfatória em diversos aspectos, apresentando redução das frequências cardíaca e respiratória, bem como mudanças comportamentais relacionadas à sensação de medo dos animais, proporcionando um relaxamento momentâneo em mais de 65% dos cães estudados.
... In fact, it may cause more harm than good. [4] Ear candling appears to be popular recently as it is widely advertised, though the mechanism of action has not been verified, and there has been no reliable evidence of a favorable clinical effect. ...
Abstract
Objectives: Cerumen production is a protective process for the ear canal. Cerumen impaction causes unpleasant symptoms. There are various cerumen removal practices. These include irrigation, application of softeners/solvents, mechanical removal, and micro‑suction. However, during the lockdown period of the COVID‑19 pandemic, some patients opted for some procedures, such as ear candling, which are not evidence‑based. This study aimed to explore the awareness of ear candling among otolaryngology doctors and record cases with complications of such practice in the Kingdom of Saudi Arabia (KSA). Methods: This was a cross‑sectional study. A questionnaire was developed after an extensive literature search, and distributed to otolaryngology residents, fellows, and consultants of different hospitals across the country. A total of 80 respondents agreed to participate in the study. Results: A total of 16 doctors reported seeing cases of ear candling, of which 13 patients had different complications, of which ear pain was the most commonly reported. The majority of participants (42.5%) thought the lack of medical access during lockdown enhanced the practice of alternative medicine for ear‑related complaints in society compared to 35% of participants who had a neutral response regarding this idea and 22.5% who disagreed. Conclusions: Although the practice of ear candling is not widely spread in KSA, different types of ear complications were recorded by the otolaryngologist. We would like to encourage the doctors to report such complications, especially after the lockdown period.
... Additionally, EC was attempted in a group of volunteers in a clinical study and was found inefficient [8]. In 2004, Ernst reviewed the literature on EC and reported that this method did not provide any supporting evidence and was unscientific [9]. ...
... One interesting highly popularized misconception that crosses multiple fields of health research is that of cleansing or detoxes for use in "removing toxins", harmful substances, or cancer cells from the body. The body has a series of organs (liver and kidneys) and natural processes in place to complete these tasks and there remains no evidence to date for any magic potion to replace these processes; in fact, the harmful effects on fluid balance and loss of nutrients need to be considered [164][165][166][167][168][169]. At this time, we would promote general recommendations that individuals avoid heavy consumption of alcohol and eat a healthy, well balanced diet, to ensure proper organ function continues. ...
Simple Summary
The involvement of microbes (virus, fungi, bacteria) and diet in different cancers is slowly being uncovered, yet the complexity of the relationship between these factors has reduced the impact of potential interventions in the clinic. In this review we have highlighted the results of the most recent studies published and have related what the evidence suggests and how we can utilize this knowledge best in directing patients’ diets and future research at this time.
Abstract
Many studies performed to date have implicated select microbes and dietary factors in a variety of cancers, yet the complexity of both these diseases and the relationship between these factors has limited the ability to translate findings into therapies and preventative guidelines. Here we begin by discussing recently published studies relating to dietary factors, such as vitamins and chemical compounds used as ingredients, and their contribution to cancer development. We further review recent studies, which display evidence of the microbial-diet interaction in the context of cancer. The field continues to advance our understanding of the development of select cancers and how dietary factors are related to the development, prevention, and treatment of these cancers. Finally, we highlight the science available in the discussion of common misconceptions with regards to cancer and diet. We conclude this review with thoughts on where we believe future research should focus in order to provide the greatest impact towards human health and preventative medicine.
... The best way of achieving a healthy weight includes a healthy diet with an energy level that does not exceed energy expenditure and can be sustained in the long term [15][16][17] detoxification is originally a medical procedure used to wean the body of toxins such as excess alcohol and drugs but food faddists believe it is aimed at cleansing the body of alleged toxins derived from metabolic by-products [18]. Many studies demonstrated that there is no evident benefit for detoxification however; it has been associated with risks which depends on the nature of the detox treatment and can be particularly serious with diets (malnutrition) and supplements (hepatoxicity) [19][20][21][22]. Although many studies have shown that the body has enough capacity to get rid of several toxins through the functions of certain organs, foods such as milk thistle, turmeric and green tea have been reported to facilitate this process [23]. ...
Food faddism; its determinants, prevalence and practices among adult university students in Ghana
Authors: Frederick Vuvor, Linda Fabea and Obed Harrison
Abstract
Background: Fad food is any diet that either eliminates one or more of the essential food groups, or recommends consumption of one type of food in excess at the expense of other foods for extraordinary health benefit. They rarely follow sound nutritional principles and focus on ingesting fewer calories along with medicinal herbs. They are generally not endorsed by the medical profession. It is of an extreme, exploitive and dubious nature, intended to produce results more quickly. The practice is termed food faddism, and anyone who practices it is called a food faddist. It has been found to have negative effects on the health of the practitioner. Identifying the determinants, quantifying the prevalence and eliciting the nature of the practice would help health professionals to address it. Methods: This study was cross-sectional involving 150 university students in Ghana. WHO Stepwise questionnaires were modified to collect all information. The data were analysed using SPSS and Excel software. Results: Prevalence of any form of food faddism was found to be 65.3%. Ethnicity and occupation of household head were found to be influencing factors associated with the practice. Major explanations given for the practice were detoxification (48.0%) and enhancing of the functions of some body parts (41.3%). Foods associated with food faddism were mostly among fruits, vegetables, seeds and herbs. Conclusion: Prevalence of food faddism was found to be unacceptably high among these students of higher learning (University). It can be inferred that if the prevalence of food faddism is so high among university students, then it could be projected that worse occurrences may be happening among people of lower levels of education.
... Ear candling has appeared since the ancient cultures, some have documented ear candle started back in Ancient Egypt [4]. There were other sources which explained that ear candling was known as "ear cone" because when the cone-shaped pottery was placed into the person's ear, smoke from burning herbs will be funnelled down into the ear canal and this supposedly cleaned the ear canal and pulled the cerumen out by vacuum [5,6]. ...
... Some outrageous benefits are also advocated to ear candling such as controlling autoimmune diseases or cancers (3). But all these claimed benefits come with real dangers as: ...
Ear candling is an alternative medicine practice alleged to enhance general health by putting an end of a hollow candle in the ear canal and lighting up the other end of it. It also is advertised for cerumen and debris (bacteria and fungi) removal. Ear candling is claimed to create negative pressure for drawing cerumen from the ear and to benefit the ears in many ways. It is however not free of complications and is now banned. Here we would like to highlight potential complications to this.
... The irrigation solution flows out of the canal along its floor, taking wax and debris with it. The solution used to irrigate the ear canal is usually warm water, 17 normal saline, 20 sodium bicarbonate solution, 30 or a solution of water and vinegar to help prevent secondary infection. 17 Patients generally prefer the irrigation solution to be warmed to body temperature, 20 as dizziness is a common side effect of syringing with fluids that are colder or warmer than body temperature. ...
... There are also case reports of ossicular disruption, round window fistula, and subluxation of the stapedial footplate from using these devices 10.11 . Additionally candling has been used more frequently as a home remedy for cerumen but it was not found to create significant suction and there was a significant danger of facial burns 12,13 . ...
The WaxVac ear cleaning device may be a useful adjunct for patients requiring aural toilet.
Cerumen removal and routine aural toilet is a common complaint that presents to the otolaryngology clinic. We tested this device to make an appropriate recommendation to our patients.
We conducted in vitro testing of the WaxVac device on an artificial ear canal model and cadaveric temporal bones testing the strength of the suction, noise created by the device, and the ability of the device to remove foreign bodies from the external auditory canal. These foreign bodies included a PE tube, baby powder, a q-tip head, saline, and artificial cerumen.
The WaxVac created very little suction as compared with Frazier tip suctions used in clinic. The device produced very little noise in the canal, which was equivalent to a #3 Frazier tip suction. The WaxVac was unable to remove q-tip heads or artificial cerumen from the ear canal model or the cadaveric temporal bones. Very little of the saline could be removed by the WaxVac, and only 20% to 50% of trials demonstrated removal of a PE tube. However, a large amount of the powder was able to be removed by the device.
Although the concept of this device is good, the actual product does not produce adequate suction to remove cerumen or most common foreign bodies from the external auditory canal. It is unlikely to be useful for aural toilet.
... The candle is then lit and burned for about 15 minutes. 2 After the procedure is finished, a brown waxy substance, believed by ear candling practitioners to be a mixture of ear wax, debris, and bacteria, is left in the candle stub. 3 Ear candling can be performed by beauticians, alternative therapists, or by patients using kits at home. ...
Ear wax accumulation is one of the most common oto�logic conditions seen in primary care; removing ear wax is the most common ears, nose, and throat proce�dure carried out in the community.
With the increasing use of and interest in complementary medicine in the United Kingdom and elsewhere, it is not surprising that
ear candling has developed such a following. Ear candling involves placing a hollow candle (made from a fabric tube soaked in beeswax) in the exter�nal auditory canal. The candle is then lit and burned
for about 15 minutes. After the procedure is finished, a brown waxy substance, believed by ear candling practi�tioners to be a mixture of ear wax, debris, and bacteria, is left in the candle stub.
Ear candling can be performed by beauticians, alter�native therapists, or by patients using kits at home. It is used mainly to remove ear wax, though it has also been used to try to relieve sinus pain, cure ear infections, help relieve tinnitus and vertigo, and even strengthen the
brain! Patients considering such alternative therapies might want to get advice from their GPs first.
We present a case of ear candling with a complica�tion and discuss the current literature.
A common refrain heard from people with tinnitus is, “My doctor said there’s nothing that can be done.” This chapter shows that there are, in fact, are many steps that people can take to help themselves. However, there is no clear signposting through this confusing maze of potential self-treatments and this is of concern as whilst some self-management techniques have been shown to be of benefit, for others the evidence of effectiveness is less conclusive, and for some, there is evidence of no effect or indeed potential harm. It is important for health professionals and patient support organisations to encourage and facilitate evidence-based autonomous interventions such as tinnitus support groups, using reliable information and self-help books, sound therapy and relaxation techniques. People with tinnitus should be discouraged from trying dietary supplements, lasers, and ear-candling. Information from the Internet or social media, and participation in chatrooms and forums can have benefits, but the quality and reliability of information is variable and could lead to an increase in tinnitus distress.
Rigorous, large-scale studies are called for as a stronger evidence base would help people make better informed decisions about the options they choose to self-manage their tinnitus.
Numerous alternative treatments are physical by nature. They often require a hands-on approach of an alternative practitioner. In this chapter, I discuss treatments that fall into this category.
Background
Perfect hearing is crucial to the practice of various professions, such as instrument makers, musicians, sound engineers, and other professions not related to music, such as sonar technicians. For people of these occupational groups, we propose the term “professional ear user” (PEU) in analogy to “professional voice user”. PEUs have special requirements for their hearing health, as they have well-known above-average auditory perceptual abilities on which they are professionally dependent.Objective
The purpose of this narrative review is to summarize selected aspects of the prevention, diagnosis, and treatment of ear disorders in PEUs.Results and conclusionPrevention of hearing disorders and other ear diseases includes protection from excessive sound levels, avoidance of ototoxins and nicotine, and a safe manner of cleaning the outer auditory canal. Diagnosing hearing disorders in PEUs can be challenging, since subclinical but relevant changes in hearing cannot be reliably objectified by conventional audiometric methods. Moreover, the fact that a PEU is affected by an ear disease may influence treatment decisions. Further, physicians must be vigilant for non-organic ear diseases in PEUs. Lastly, measures to promote comprehensive ear health in PEUs as part of an educational program and to maintain ear health by means of a specialized otolaryngology service are discussed. In contrast to existing concepts, we lay the attention on the entirety of occupational groups that are specifically dependent on their ear health in a professional setting. In this context, we suggest avoiding a sole focus on hearing disorders and their prevention, but rather encourage the maintenance of a comprehensive ear health.
Akupressur ist die Stimulation spezifischer Punkte, auf der Körperoberfläche durch Druck zu therapeutischen Zwecken. Der erforderliche Druck kann manuell oder mit einer Reihe von Instrumenten ausgeübt werden.
Acupressure is the stimulation of specific points, called acupoints, on the body surface by pressure for therapeutic purposes. The required pressure can be applied manually of by a range of devices. Acupressure is based on the same tradition and assumptions as acupuncture. Like acupuncture, it is often promoted as a panacea, a ‘cure all’.
Tinnitus: A Multidisciplinary Approach provides a broad account of tinnitus and hyperacusis, detailing the latest research and developments in clinical management, incorporating insights from audiology, otology, psychology, psychiatry and auditory neuroscience. It promotes a collaborative approach to treatment that will benefit patients and clinicians alike. The 2nd edition has been thoroughly updated and revised in line with the very latest developments in the field. The book contains 40% new material including two brand new chapters on neurophysiological models of tinnitus and emerging treatments; and the addition of a glossary as well as appendices detailing treatment protocols for use in an audiology and psychology context respectively.
Tinnitus can be defined as the perception of a sound in the head or the ears, in the absence of external acoustic stimulation. It is a symptom experienced by more than seven million people across the UK and many more worldwide, including children. Its pitch may vary from individual to individual, and it can be described as ringing, whistling, humming or buzzing amongst other. We will be looking at the contemporary theories for its generation, current methods of diagnosis and management practices.
Cerumen, or earwax, is the product of the sebaceous and ceruminous glands combined with débrided epithelial cells and hair from the external auditory canal. Cerumen is usually extruded by a combination of jaw movements from chewing and speech, and natural epithelial migration. However, cerumen may become impacted, especially among older adults and individuals with mental retardation. Cerumen impaction may cause hearing bss, otitis externa, vertigo, tinnitus, or cough. There are multiple methods for removing earwax, with limited evidence to support any of the current practices. Irrigation or manual disimpaction using a curette have long been the accepted earwax removal methods, yet neither has been subjected to comparative trials with other methods. Irrigation alone is effective in up to 70% of cases of impacted cerumen. Ceruminolytics or eardrops are effective in up to 40% of cases without irrigation, and when combined with irrigation can be effective up to 97%. Cotton ear buds and ear candling should be avoided.
The "American Academy of Otolaryngology - Head and Neck Surgery Foundation" has issued the first comprehensive clinical guidelines for assessment, management, and treatment of impacted cerumen. Despite the high frequency and its important repercussions on health care management in Italy, Italian epidemiological data on earwax impaction have never been published before. Another factor differentiating the management of earwax impaction, between Italy and other countries, is a generalized tendency to reserve the diagnosis and treatment of this pathological condition almost exclusively to otolaryngologists and otologists. General practitioners and nurses usually neglect this pathological condition, as well as its treatment, resulting in few complications, on the one hand, and in an increase in the public health costs, on the other. The Authors, after a comprehensive review on the definition, epidemiology, relationship with infections, genetics and treatment options of earwax impaction, report on an evaluation of the ENT consultations from 1st January to 31st December 2008, at their hospital ENT Department. The consultations for earwax management account for an average rate of 12.80% of the total ENT consultations in the same timeframe. The question whether cerumen protects the ear against micro-organisms or, instead, supports their growth, has long been, and still remains, a subject of controversy. Interesting relationships between cerumen and other systemic diseases (psoriasis, cystic fibrosis, alkaptonuria, Parkinson disease, breast cancer, arteriosclerosis, etc.) have been described. Finally, the implications of earwax on industrial audiometry are discussed, mainly concerning the difficulty in treating earwax impaction in the industrial setting and the effect of cerumen on aural acuity. The Authors report results of a study on hearing threshold improvement following relief of earwax impaction in industrial noise-exposed workers.
Through four successive articles we aim to show the procedures we consider to be most useful for the diagnosis and follow-up of otitis media with effusion (OME) by Primary care Pediatrics. In the first one, we expose what we believe is the best way to clean wax from the ear of a child. The conclusions provided combine the recommendations offered by the main guides on extraction of wax from the ear and the literature review carried out, with the experience of a team of pediatricians and otolaryngologists from the same Healthcare Area. Around 50% of children require clean wax from their ears in order to perform a correct otoscopy. To do this we can use the instillation of cerumenolytics, irrigation, manual removal, or any combination. There is no evidence in the literature that a procedure is better than another one. Conclusions: after applying different cleaning techniques, we believe that if the wax is external and the ear canal permeable, the best way to remove it is by the use of blunt ear curettes or applicator with triangular tip, but if the wax is deeper or is impacted, the better choice will be washing with warm water irrigation, in this case, the previous application of a cerumenolytic will be of great help. We advise to perform such irrigation with a syringe of 20 cc and an intravenous catheter Abocat® 14-16, in order to avoid risks. © 2015 Spanish Association of Primary Care Pediatrics. All rights reserved.
Through four successive articles we aim to show the procedures we consider to be most useful for the diagnosis and follow-up of otitis media with effusion (OME) by Primary care Pediatrics. In the first one, we expose what we believe is the best way to clean wax from the ear of a child. The conclusions provided combine the recommendations offered by the main guides on extraction of wax from the ear and the literature review carried out, with the experience of a team of pediatricians and otolaryngologists from the same Healthcare Area. Around 50% of children require clean wax from their ears in order to perform a correct otoscopy. To do this we can use the instillation of cerumenolytics, irrigation, manual removal, or any combination. There is no evidence in the literature that a procedure is better than another one. Conclusions: after applying different cleaning techniques, we believe that if the wax is external and the ear canal permeable, the best way to remove it is by the use of blunt ear curettes or applicator with triangular tip, but if the wax is deeper or is impacted, the better choice will be washing with warm water irrigation, in this case, the previous application of a cerumenolytic will be of great help. We advise to perform such irrigation with a syringe of 20 cc and an intravenous catheter Abocat® 14-16, in order to avoid risks.
Rosemary Rodgers highlights some case studies and reviews some of the evidence on ear irrigation, and makes recommendations for safe and effective ear care
Earache, a common emergency department presentation, may be caused by a variety of conditions, some distant from the ear. This article discusses the diagnosis and treatment of acute otitis media, otitis media with effusion, otitis externa, otitis media with ruptured tympanic membrane or tympanostomy tubes, malignant otitis externa, mastoiditis and petrositis, traumatic ruptured tympanic membrane, cerumen impactions, and foreign bodies in the ears.
The concept that alternative therapies can eliminate toxins and toxicants from the body, i.e. 'alternative detox' (AD) is popular.
Selected textbooks and articles on the subject of AD.
The principles of AD make no sense from a scientific perspective and there is no clinical evidence to support them.
The promotion of AD treatments provides income for some entrepreneurs but has the potential to cause harm to patients and consumers.
In alternative medicine, simplistic but incorrect concepts such as AD abound. AREAS TIMELY FOR RESEARCH: All therapeutic claims should be scientifically tested before being advertised-and AD cannot be an exception.
Objective:
This guideline provides evidence-based recommendations on managing cerumen impaction, defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. We recognize that the term "impaction" suggests that the ear canal is completely obstructed with cerumen and that our definition of cerumen impaction does not require a complete obstruction. However, cerumen impaction is the preferred term since it is consistently used in clinical practice and in the published literature to describe symptomatic cerumen or cerumen that prevents assessment of the ear. This guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction.
Purpose:
The primary purpose of this guideline is to improve diagnostic accuracy for cerumen impaction, promote appropriate intervention in patients with cerumen impaction, highlight the need for evaluation and intervention in special populations, promote appropriate therapeutic options with outcomes assessment, and improve counseling and education for prevention of cerumen impaction. In creating this guideline the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of audiology, family medicine, geriatrics, internal medicine, nursing, otolaryngology-head and neck surgery, and pediatrics.
Results:
The panel made a strong recommendation that 1) clinicians should treat cerumen impaction that causes symptoms expressed by the patient or prevents clinical examination when warranted. The panel made recommendations that 1) clinicians should diagnose cerumen impaction when an accumulation of cerumen is associated with symptoms, or prevents needed assessment of the ear (the external auditory canal or tympanic membrane), or both; 2) clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as one or more of the following: nonintact tympanic membrane, ear canal stenosis, exostoses, diabetes mellitus, immunocompromised state, or anticoagulant therapy; 3) the clinician should examine patients with hearing aids for the presence of cerumen impaction during a healthcare encounter (examination more frequently than every three months, however, is not deemed necessary); 4) clinicians should treat the patient with cerumen impaction with an appropriate intervention, which may include one or more of the following: cerumenolytic agents, irrigation, or manual removal other than irrigation; and 5) clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should prescribe additional treatment. If full or partial symptoms persist despite resolution of impaction, alternative diagnoses should be considered. The panel offered as an option that 1) clinicians may observe patients with nonimpacted cerumen that is asymptomatic and does not prevent the clinician from adequately assessing the patient when an evaluation is needed; 2) clinicians may distinguish and promptly evaluate the need for intervention in the patient who may not be able to express symptoms but presents with cerumen obstructing the ear canal; 3) the clinician may treat the patient with cerumen impaction with cerumenolytic agents, irrigation, or manual removal other than irrigation; and 4) clinicians may educate/counsel patients with cerumen impaction/excessive cerumen regarding control measures.
Disclaimer:
This clinical practice guideline is not intended as a sole source of guidance in managing cerumen impaction. Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. It is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and may not provide the only appropriate approach to diagnosing and managing this problem.
We describe a case of ear candling presenting as hearing loss, and review the literature. Ear candling is considered as an alternate medical therapy for dewaxing the ears, discomfort in ears and sinuses, rhinitis, sinusitis, glue ear, colds, flu, migraines, poor or "muffled" hearing, high stress, and ringing in the ear. There is no evidence of its effectiveness, and it can actually cause damage to the ears.
The review of the literature and some media data referring to chosen methods of unconventional treatment, its history of the development in Poland and around the world has been made in this paper (homeopathy, waxing of ears, bio-energy therapy) and the increasing interest among the treated patients has been shown. It is essential that the doctors (including laryngologists) while carrying out the interview should take the unconventional way of treatment of patients into consideration. This may explain the registering of patients to appropriate treatment in the advanced state of illness, which is particularly unprofitable in cancer-afflicted states.
Cerumen is a naturally occurring, normally extruded product of the external auditory canal. It is usually asymptomatic, but when it becomes impacted it can cause complications such as hearing loss, pain, or dizziness. It also can interfere with examination of the tympanic membrane. Depending on available equipment, physician skill, and patient circumstances, treatment options for cerumen impaction include watchful waiting, manual removal, the use of ceruminolytic agents, and irrigation with or without ceruminolytic pretreatment. The overall quality of the evidence on treatment is limited. Referral to an otolaryngologist for further evaluation is indicated if treatment with a ceruminolytic agent followed by irrigation is ineffective, if manual removal is not possible, if the patient develops severe pain or has vertigo during irrigation, or if hearing loss is still present after cerumen has been removed. The use of cotton swabs and ear candles should be avoided.
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