Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal Vol.35, 2017 86 Significance of Ear Wax Impaction in School Children: A Case of Winneba West Circuit, Ghana Sesi Collins Akotey 1 Edward Kodzo Adza 2 Adam Awini 1 Joana Beyebenwo Cobbinah 2 Kenneth Darko 2 Eric Worlanyo Ador 2 Lydia Polley Arckertson 2 Patience Dadzie-Bonney 2 Charles Adzoe 2 Belinda Asamoah 2 Anthony Atandigre Agomboka 2 1.Department of Special Education, University of Education, Winneba, P. O. Box 25, Winneba Ghana 2.Ghana Education Service, Effutu Municipal Education office, P. O. Box 49, Winneba The research is financed by authors Abstract Cerumen or earwax is a mixture of secretions that is sebum together with secretions from modified apocrine glands and sloughed epithelial cells present in the external auditory canals of humans. Earwax impaction is one of the most common reasons patients seek medical care for ear-related problems such as blockage and conductive hearing impairment. However, in Ghana there is virtually no literature on earwax impaction among school children. The aim of the study was to determine the prevalence of school children with wax impaction in Government assisted basic schools in the Winneba West circuit of the Effutu Municipal. This cross-sectional study included 4407 children between the ages of 5 to 16 years from 11 government assisted basic schools in the Winneba West circuit, of the Effutu municipal, Ghana. The instruments used were otoscopy and interview of randomly selected children on the use of cotton-tipped ear swabs for cleaning their ears. Out of the 4407 children, earwax impaction was found in 988 (22.4%). There was a marginal difference in the prevalence of earwax impaction in females compared to males; that is, of the 988 with earwax impaction 522 (53%) were females and 466 (47%) were males. However, the use of cotton-tipped swab could not be directly associated with earwax impaction. Earwax impaction and its attendant challenges is a problem amongst Ghanaian basic school children. The high prevalence of earwax impaction among basic school children in Winneba (Ghana) can lead to conductive hearing impairment which can affect the academic performance of the children negatively. Regular hearing screening involving processes such as otoscopy at the entry point and at regular intervals is being recommended for early identification and remediation. Keywords: Ear wax (cerumen) impaction, Cotton-tipped swab Background Earwax (cerumen) is composed of secretions, sloughed epithelial cells and hair from the external auditory canal that protects the skin in the canal and is naturally extruded (Brkic 2010; Gelfand 2009; Oron et al. 2011). According to Brkic (2010) there are four types of earwax (cerumen): European, Vietnamese, dried Inuit and dried epithelium. However, Hydri and Siddiqui (2016) report of two types of earwax: wet and dry. They (Hydri & Siddiqui 2016) explained that both the wet and dry earwax is determined by a single nucleotide polymorphism (SNP)/538G>A (Gly180Arg) in the ABCC gene (ABCC11). Dry wax is prevalent in East Asians, whereas wet earwax is common in other population worldwide (Hydri et. al. 2016). Cerumen in normal amounts is usually asymptomatic, serves as a self-cleaning agent with protective, lubricating and antibacterial properties but, when it becomes impacted it can cause complications such as hearing loss, pain, itching or dizziness, which can interfere with the examination of the tympanic membrane (Gelfand 2009; Hydri et. al. 2016; McCarter, Courtney & Pollart 2007; Saana et al. 2014; Weinstein 2009). However, the unique anatomy and physiology of the external auditory canal allows an efficient self-cleaning system to rid the canal of earwax. While some people have a completely clean ear without ever having them cleaned, others have excessive production of earwax. Brkic (2010) posit that two populations are known to have a high incidence of impacted earwax: individuals with mental retardation and the elderly. Similarly, McCarter et al. (2007), Williams (2008), and Peter et al. (2008) observed that earwax impaction is present in approximately 10% of children, 5% of normal healthy adults, up to 57% of older patients in nursing homes, and 36% of patients with mental retardation. The COSLPO - Preferred Practice Guideline for Cerumen Management Report (2005), Oron et. al. (2010) indicates that cerumen impaction is the most common ear problem encountered by general practitioners, and the primary cause of conductive hearing loss. Cerumen impaction may affect hearing and decrease hearing acuity by 40-45 dB (Oron et. al. 2010). Such hearing impairment among school children as well as adults is very significant and can have a toll on their academic output, communication, social development and even physical mobility (Oron et. al. 2010). The Effutu Municipal is located in the Central Region of Ghana about 56 km west of Accra and 140 km east of Cape Coast. Winneba is its capital town of the Municipal. It has a population of over 60,000. The Educational Directorate of Government Assisted Public Basic schools are manned by a Director under three