General Practice, Oettingen, Germany.
University Medicine, Greifswald, Mecklenburg-Vorpommern, Germany.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720973829. doi: 10.1177/2150132720973829.
Ear irrigation is a commonly used method for removing earwax in general practice. There is no firm evidence if no pre-treatment is as good as pre-treatment with various standard preparations.
To assess the effectiveness of no pre-treatment compared to pre-treatment with commercially available cerumenolytics and to assess which preparation is best suited for pre-treatment.
This is a pragmatic observational study of patients with cerumen treated from a single GP with 3 different preparations or no preparation prior to standardized ear irrigation. Generalized linear mixed models with logit link function were performed to assess the effectiveness of pre-treatment with different preparations and no pre-treatment. The models were adjusted for age group (<70, ≥70) and sex.
A total of 168 patients (298 ears, 58 % female, median age 65 years) consulted for obstructive cerumen, some of them several times. The cerumen was successfully removed in 70% (208/298). Comparing any preparation to no preparation (aggregated comparison), the odds ratio for complete clearance was 1.35 (95%confidence interval: 0.69-2.65). Comparing the preparations individually, the odds ratio of the docusate-sodium-based preparation was 1.87 (95% CI: 0.79-4.42) indicating a higher effectiveness. Although, not statistically significant. Ear irrigation was less successful for patients aged ≥ 70 years (OR = 0.48, 95% CI: 0.23-0.98).
The aggregated comparison indicates a slight trend toward a higher effectiveness of any pre-treatment compared to no pre-treatment. The effect-size of docusate-sodium-based pre-treatment indicates a higher effectiveness of cerumen impaction removal. Nevertheless, superiority could not be shown conclusively according to the statistical significance given the restricted sample size.
耳冲洗是一种常用于普通实践中清除耳垢的方法。没有确凿的证据表明未经预处理与各种标准制剂预处理一样好。
评估与市售耵聍软化剂预处理相比，不预处理的效果，并评估哪种制剂最适合预处理。
这是一项关于在一位全科医生治疗下，使用 3 种不同制剂或不进行预处理，然后进行标准化耳冲洗的患者的实用观察性研究。使用具有对数链接函数的广义线性混合模型来评估不同制剂预处理和不预处理的效果。模型根据年龄组（<70 岁、≥70 岁）和性别进行调整。
共有 168 名（298 只耳朵，58%为女性，中位年龄 65 岁）因阻塞性耵聍就诊，其中一些人多次就诊。70%（208/298）的耵聍被成功清除。将任何制剂与无制剂（汇总比较）进行比较，完全清除的优势比为 1.35（95%置信区间：0.69-2.65）。单独比较制剂时，多库酯钠制剂的优势比为 1.87（95%置信区间：0.79-4.42），表明效果更高。尽管没有统计学意义，但≥70 岁的患者的耳冲洗成功率较低（OR=0.48，95%CI：0.23-0.98）。
汇总比较表明，任何预处理与无预处理相比，效果略有提高。多库酯钠制剂预处理的效果大小表明，耵聍栓塞去除的效果更高。然而，根据有限的样本量给出的统计学意义，无法得出结论性的优势。
