NATIONAL JOURNAL OF MEDICAL RESEARCH print ISSN: 2249 4995│eISSN: 2277 8810 Volume 3│Issue 2│Apr – June 2013 Page 126 ORIGINAL RESEARCH EAR SYRINGING - TRENDS FROM A YOUNG ENT PRACTICE IN NIGERIA Taiwo O Adedeji 1 , Olusola A Sogebi 2 , Sahabi A Bande 3 Authors’ Affiliation: 1 ENT Department, LAUTECH Teaching Hospital, Osogbo; 2 ENT Department, Olabisi Onabanjo University Teaching Hospital, Sagamui; 3 Department of Ear Nose and Throat, Federal Medical Center Birnin Kebbi, Kebbi State, Nigeria. Correspondence: Taiwo Olugbemiga Adedeji, Email: adedejitaiwo2003@yahoo.com ABSTRACT Background: Ear syringing is a procedure by which the external auditory canal is irrigated with saline at body temperature. It is a common otorhinolaryngology clinic procedure. This study aims to find out the trends of ear syringing as seen in a tertiary health institution in Nigeria. Methodology: The study was a retrospective review of all patients that were managed with ear syringing in the department of Otorhinolaryngology, Federal Medical Center Birnin Kebbi, Nigeria, over a four year period. Results: A total of 557 patients consisting of 290 males and 267 females with M: F 1.1:1. The ages of the patients ranged from 1 – 86years. Syringing was done in 26.4% in the right ear, 30.2% in the left ear and 43.5% in both ears. Majority of the syringing were done by ENT trained nurses. About Ninety percent (90.7%) of the patients had successful syringing once and had subjective improvement in hearing. Complications were recorded in 5% of the patients. The complications were vertigo 0.7%, external auditory canal abrasion 2.2% and failure of procedure in 2.2%. Most (98.0%) complications occurred among the nurses while the remaining complications (2%) occurred with the resident ENT medical officers. Conclusion: Trends of ear syringing have not changed. Ear syringing, though may appear simple should be performed with care. Proper training and re - training with particular attention to the technique of syringing as well as to contraindications to syringing to make the procedure safe and cost effective are advised. Keywords: Ear syringing, Indications, Trends, Complications, Nigeria. INTRODUCTION Ear syringing, a procedure by which the external auditory canal is irrigated with a normal saline at body temperature, is a common otorhinolaryngologic procedure. 1 It is the act of removing earwax, dead skin or a foreign body or debris by way of gentle flushing with warm saline via a narrow nozzle/ cannula attached to a syringing device 2 . Though syringing of the ear is a common procedure, adequate knowledge of anatomy and physiology of the ear as well as training is required for effective syringing to avoid complications. Although ear syringing has been ascribed to be one of the most common sources of iatrogenic otorhinolaryngologic problems 3 , in the experienced hand, it is efficient, easy to perform and non-traumatic on the patient. Ear wax (cerumen auris) impaction is the most common reported indication for syringing of the ear. 1,4,5 American Academy of Otolaryngology-Head and Neck Surgery Foundation defined wax impaction as accumulated cerumen that is symptomatic or prevents adequate examination of the external auditory canal, tympanic membrane, or both 4 . Prevalence of wax impaction in USA was found to be 10% among children, 5% among healthy adult and up to 57% in older persons in nursing homes 6 and it is found to be disproportionately more common in children and elderly Nigerians. 6,7,8 . Various methods used in the removal of ear wax include the use of ceruminolytic agents, curette method (using either a Jobson-Horne probe or St. Bartholomew wax hook) and lavage 1 but ear syringing is the most employed and efficient method for removing ear wax 5 . Foreign body removal from external auditory canal is another indication for ear syringing 5 . This is usually done for non vegetative and animate foreign bodies 9, 10 . Live insect is first drowned in alcohol or mineral oil before syringing 9 . Ear syringing for foreign body removal is contraindicated in cases of vegetative FB, button batteries or perforated tympanic membrane 9 . Other indication for ear syringing is for removal of debris accumulated in the external auditory canal secondary to canal infection 5 (otitis externa). This can result from fungal infection (otomycosis) or bacterial infection. Syringing for this condition is done to clear the external auditory canal of this debris for effective treatment by antifungal / antibacterial agent.