Research & Development Office, The Surgery, Overton, Hampshire, United Kingdom.
Ann Fam Med. 2011 Mar-Apr;9(2):110-4. doi: 10.1370/afm.1229.
Bulb syringes can be used for the self-clearance of earwax and, in the short term, appear effective. We compared the long-term effectiveness of self-irrigation using a bulb syringe with routine care in United Kingdom (UK) family practice clinics where irrigating ears to remove wax is a common procedure.
We assessed the impact on health service utilization as a follow-up to a single-blind, randomized, controlled trial of 237 patients attending 7 UK family practice clinics with symptomatic, occluding earwax who were randomized to an intervention group (ear drops, bulb syringe, instructions on its use and reuse) or a control group (ear drops, then clinic irrigation). After 2 years, a retrospective notes search for earwax-related consultations was carried out. We used an intention-to-treat analysis to assess differences in dichotomous outcomes between groups.
In the 2-year trial follow-up, more control group patients returned with episodes of earwax: 85 of 117 (73%) control vs 70 of 117 (60%) intervention, χ(2)=4.30; P = .038; risk ratio 1.21 (95% CI, 1.01-1.37). The numbers of consultations amounted to 1.15 (control) vs 0.64 (intervention) (incidence rate ratio 1.79; 95% CI, 1.05-3.04, P = .032), ie, a difference of 0.50 consultations, thus saving a consultation on average for every 2 people.
For patients who have not already tried bulb syringes, self-irrigation using a bulb syringe significantly reduces subsequent demand for ear irrigation by health professionals. Advocating the initial use of bulb syringes could reduce demand for ear irrigation in family practice clinics.
球囊式洗耳器可用于自行清除耳垢，且在短期内似乎有效。我们比较了在英国（UK）家庭诊所中使用球囊式洗耳器进行自我冲洗与常规护理的长期效果，在这些诊所中，冲洗耳朵以清除耳垢是一种常见的操作。
我们评估了对健康服务利用的影响，这是对 237 名在 7 家英国家庭诊所就诊的、有症状性、阻塞性耳垢的患者进行的一项单盲、随机、对照试验的随访，这些患者被随机分配到干预组（滴耳液、球囊式洗耳器、使用和重复使用说明）或对照组（滴耳液，然后在诊所冲洗）。2 年后，对与耳垢相关的就诊记录进行了回顾性检索。我们采用意向治疗分析来评估组间二分类结局的差异。
在 2 年的试验随访中，对照组中更多的患者因耳垢问题再次就诊：对照组 117 人中的 85 人（73%）vs 干预组 117 人中的 70 人（60%），χ(2)=4.30；P =.038；风险比 1.21（95%CI，1.01-1.37）。就诊次数为对照组 1.15 次（对照组）vs 干预组 0.64 次（干预组）（发病率比 1.79；95%CI，1.05-3.04，P =.032），即平均每次就诊减少 0.50 次，因此，每 2 人中就有 1 人可避免就诊。
对于尚未尝试过球囊式洗耳器的患者，使用球囊式洗耳器进行自我冲洗可显著减少后续对专业医护人员进行耳部冲洗的需求。提倡最初使用球囊式洗耳器可能会减少家庭诊所中对耳部冲洗的需求。
