Cerumenolytic Effects of Carbamide Peroxide in Patients with Ear Wax Obstruction

Document Type : Original

Authors

1 Faculty of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.

2 Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Department of Otolaryngology, Valiasr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

10.22038/ijorl.2024.67777.3311

Abstract

Introduction:
Accumulated and compacted ear wax or cerumen can cause conductive hearing loss, discomfort and vertigo, and infection. This study investigates the effect of Carbamide peroxide (CP) compared with Phenol glycerin (PG) ear drops on cerumen.
Materials and Methods:
This experimental study investigated the effect of PG and CP ear drops on cerumen in ex vivo and in vivo phases. In the ex vivo phase cerumen degredation was scored following PG and CP treatments. In the in vivo phase, 29 patients with bilateral cerumen impaction were randomly entered the study. PG and CP were applied 3 times a day (each time 5 drops) for 4 days by patients. After treatments, the time of cerumen removal was measured.
Results:
Instant changes showing degredation of cerumen (grade 1) was evident when it was exposed to CP, on the other hand degredation changes (grade 1) in cerumen treated with PG was only evident after 20 min incubation at 37 oC, while grade 3 degredation was evident in cerumen treated with CP after the same time incubation. Although the time needed for removal of cerumen was lower in CP treatment (54.10±31.77) compared to PG treatment (67.10±35.54), the difference was not statistically significant.
Conclusion:
Based on the literature and our results, carbamide peroxide is suggested as a proper treatment for patients with EAC obstruction caused by cerumen compaction, because not only it is significantly effective in cerumen degredation, but also no side effects have been reported.   

Keywords

Main Subjects

References

  1. Aaron K, Cooper TE, Warner L, Burton MJ. Ear drops for the removal of ear wax. The Cochrane database of systematic reviews.2018;7(7):CD0121 71 -CD.
  2. Roland PS, Smith TL, Schwartz SR, Rosenfeld RM, Ballachanda B, Earll JM, et al. Clinical practice guideline: cerumen impaction. Otolaryngol Head Neck Surg. 2008;139(3 Suppl 2):S1-s21.
  3. Shokry E, Filho NRA. Insights into cerumen and application in diagnostics: past, present and future prospective. Biochemia medica. 2017;27(3):030503-
  4. Makino K, Amatsu M. Epithelial migration on the tympanic membrane and external canal. Arch Otorhinolaryngol. 1986;243(1):39-42.
  5. Keane EM, Wilson H, McGrane D, Coakley D, Walsh JB. Use of solvents to disperse ear wax. Br J Clin Pract. 1995;49(2):71-2.
  6. Kumar Sinha A, Montgomery JK, Herer GR, McPherson DL. Hearing screening outcomes for persons with intellectual disability: a preliminary report of findings from the 2005 Special Olympics World Winter Games. Int J Audiol. 2008;47(7):399-403.
  7. Moore AM, Voytas J, Kowalski D, Maddens M. Cerumen, hearing, and cognition in the elderly. J Am Med Dir Assoc. 2002;3(3):136-9.
  8. Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Qjm. 2004; 97(8): 477-88.
  9. Hamaya M, Kataura A, Imai A, Nakao A, Kawaguchi E. [Geographic variation and biological analysis of ear wax, with special reference to biochemical and immunochemical specificity of the dry and wet ear wax]. J Dent Educ. 1969;33(4): 552-3.
  10. Carr MM, Smith RL. Ceruminolytic efficacy in adults versus children. J Otolaryngol. 2001; 30(3):154-6.
  11. Dummer DS, Sutherland IA, Murray JA. A single- blind,  randomized  study   to   compare   the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

efficacy of two ear drop preparations  (‘Audax’   and ‘Cerumol’) in the softening of ear wax. Current Medical Research and Opinion. 1992;13(1):26-30.

  1. Jaffé G, Grimshaw J. A Multicentric Clinical Trial Comparing Otocerol® with Cerumol® as Cerumenolytics. Journal of International Medical Research. 1978;6(3):241-4.
  2. Lyndon S, Roy P, Grillage MG, Miller AJ. A comparison of the efficacy of two ear drop preparations (‘Audax’ and ‘Earex’) in the softening and removal of impacted ear wax. Current Medical Research and Opinion. 1992;13(1):21-5.
  3. Meehan P. Ceruminolysis in the Pediatric Patient: A Prospective, Double-blinded, Randomized Controlled Trial. Academic Emergency Medicine. 2002; 9.
  4. Oron Y, Zwecker-Lazar I, Levy D, Kreitler S, Roth Y. Cerumen removal: comparison of cerumenolytic agents and effect on cognition among the elderly. Arch Gerontol Geriatr. 2011;52(2): 228-32.
  5. Singer AJ, Sauris E, Viccellio AW. Ceruminolytic effects of docusate sodium: a randomized, controlled trial. Ann Emerg Med. 2000; 36(3):228-32.
  6. Vanlierde MJ, Murray JA, Tse EK. A Study to look at the efficary of Almond Oil and Cerumol Ear Drops in the removal of ear wax. South African Family Practice. 1991;12.
  7. Whatley VN, Dodds CL, Paul RI. Randomized clinical trial of docusate, triethanolamine polypeptide, and irrigation in cerumen removal in children. Arch Pediatr Adolesc Med. 2003;157(12):1177-80.
Iranian Journal of Otorhinolaryngology
Volume 36, Issue 2
March and April 2024
Pages 415-420

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