Detroit — The bad news: A study by Henry Ford Hospital shows a direct association between cotton swab use and ruptured eardrum. The good news: The study also shows that, in most cases, the rupture heals on its own and surgery is only necessary for the most severe cases. The study was presented at the recent Combined Otolaryngology Spring Meeting in Chicago.

"In the past, many otolaryngologists have wondered if surgery is really necessary to treat a ruptured eardrum. The results of this study show that 97% of cases healed on their own within 2 months, proving that most cases do not require surgery," says Ilaaf Darrat, MD, an otolaryngologist at Henry Ford Hospital and co-author of the study.

More than half of patients seen in otolaryngology clinics, regardless of their primary complaint, admit to using cotton swabs to clean their ears, and if the cotton swab is pushed too far in the ear canal, it can cause tympanic membrane perforations (TMP), which can lead to facial paralysis and vertigo.

The Ford Hospital study included 1,540 patients with a diagnosis of TMP from 2001 to 2010. Patients with a cotton swab injury were subdivided into two groups: observation and surgery. Successful outcomes were defined as healed TMP, resolution or improvement of vertigo, tinnitus or facial nerve paralysis, and/or closure of the air-bone gap.

A ruptured eardrum can be treated in one of two ways, depending on the severity of the symptoms. The most common method of treatment is observation of the perforation by an otolaryngologist because often the eardrum will heal on its own within 2 months. More severe cases are treated with surgery.

While the study found that most cases of ruptured eardrum heal on their own, neurological deficits, such as facial nerve paralysis, require surgical intervention to repair the eardrum. Surgical intervention proved very successful, with only one patient suffering mild, but improved vertigo.

Study co-author Michael Seidman, MD, FACS, director of the division of otologic and neurotologic surgery at Henry Ford Hospital, recommends that instead of cotton swabs, patients should use the following alternatives to clean the inner ear:

  • Take cool peroxide, hot tap water and mix equally. Be sure it is body temperature and gently irrigate the ear one or two times per month.
  • Take plain vinegar and water and use four or five drops in the ear once a week.
  • See a doctor, who can remove ear wax for you.
  • Try an over-the-counter treatment such as Debrox.

Darrat and her colleagues concluded that proper follow-up with a doctor to test hearing after a case of ruptured eardrum is essential to ensure that no hearing loss was caused.

SOURCE: Henry Ford Hospital