Stop Using Cotton Tip Applicators in Kids’ Ears Interview with:

Kris Jatana, MD FAAP Pediatric Otolaryngologist Nationwide Children’s Hospital

Dr. Jatana

Kris Jatana, MD FAAP
Pediatric Otolaryngologist
Nationwide Children’s Hospital What is the background for this study? What are the main findings?

Response: This study looked at a 21-year period – 1990 through 2010 – and focused on children younger than 18 years of age treated in U.S. hospital emergency departments for cotton tip applicator-related ear injuries. About 263,000 children were injured during the study period, which comes out to approximately 1000 injuries seen in emergency departments every month or 34 per day.

The majority of injuries occurred when cotton tip applicators were used to clean a child’s ear canal (73%), and most of those injuries occurred when a child was using a cotton tip applicator on their own (77%), or their parent was using the device (16%) to clean the ear canal. About two out of every three patients were younger than 8 years of age, and patients aged 0-3 years accounted for 40% of all injuries.

Surprisingly, the highest rate of injury was in children 0-3 years old. The most common injuries were foreign body sensation (30%), perforated ear drum (25%) and soft tissue injury (23%). What should readers take away from your report?

Response: Even though the number of overall injuries slightly decreased during the study period, that number is still unacceptably high; younger children were more commonly injured.

The most common misconceptions are:

1) the ear canals need regularly cleaned in home setting and

2) cotton tip applicators should be used to clean them – both of those are incorrect. The ear canals are usually self-cleaning. Using cotton tip applicators to clean the ear canal not only pushes wax closer to the ear drum where it can get trapped, but minor to severe injuries can occur. These injuries include damage to the ear drum, hearing bones, or inner ear. This can lead to dizziness, problems with balance, and irreversible hearing loss. What recommendations do you have for future research as a result of this study?

Response: We do not recommend using cotton tip applicators to clean the ear canals. Is there anything else you would like to add?

Response: If parents are concerned about wax buildup in their child’s ear, we recommend consulting with their pediatrician or seeing an ear, nose, throat specialist for evaluation and an individualized treatment plan.

The authors have no disclosures related to the content of this study. Thank you for your contribution to the community.


Pediatric Cotton-Tip Applicator-Related Ear Injury Treated in United States Emergency Departments, 1990-2010
Ameen, Zeenath S. et al.
The Journal of Pediatrics , Volume 0 , Issue 0 , May 01, 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 10, 2017 by Marie Benz MD FAAD