Researchers from Nationwide Children’s Hospital found that between 1990–2010, about 263,000 children aged <18 years were treated in emergency departments for cotton tip applicator ear injuries—approximately 34 injuries per day. Findings from the study were published in The Journal of Pediatrics

Kris Jatana, MD, senior author of the study, stated, “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, but there is a significant risk of causing minor to severe injury to the ear.”

Dr. Jatana and colleagues accessed data from the National Electronic Injury Surveillance System (NEISS). Over the 21-year study period, there was a decrease in the overall number of injuries but “it is still unacceptably high.” About 40% of all injuries were comprised of patients aged 0–3 years with about 2 out of every 3 patients aged <8 years. 

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Most of the injuries were due to using cotton tip applicators to clean the ears (73%), playing with cotton tip applicators (10%), or children falling while the cotton tip applicator is in their ear (9%). The majority of injuries were inflicted by the children themselves (77%), followed by the parent (16%) or sibling (6%) who used the cotton tip applicator to clean the child’s ear. 

Study authors reported that the most common injury was foreign body sensation (30%), followed by perforated ear drum (25%) and soft tissue injury (23%). For children aged 8–17 years, foreign body sensation was the most commonly reported; for children aged <8 years, perforated ear drum was the most common. Almost all of the children seen in the emergency department (99%) received treatment and were released. 

Findings from the study emphasize that though cotton tip applicators “may seem harmless,” they are not intended to clean the ears.

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