Earwax and level of paralysis

Abstract

Study design: Inception cohort. Objectives: The clinical impression that earwax is uncommonly frequent among spinal cord injury patients with high levels of paralysis was tested. Setting: Veterans Administration Hospital, USA. Methods: A cohort of 15 chronically paralyzed patients, motor complete, living as residents in a long-term care facility was offered monthly irrigations of the ears for removal of wax over a 6-month period. The number of requests was tabulated. All ears were examined once on a single day to determine point prevalence. The accumulated wax graded as absent or small, moderate or large. Results: Two patients with C2 lesions, aged 37 and 52 years and paralyzed 15 and 16 years, were compared with 13 patients at C4-T6 aged 44-78 years, median 62 years, and paralyzed 2-33 years, median 24 years. Over a 6-month observation period, 10 irrigations were requested by the C2 patients and three by the C4-T6 patients. The reasons were hearing loss. Wax was found and removed, and symptoms were relieved in all instances, P < 0.001. The spot survey revealed earwax of moderate or large amounts in four of four C2 patient ears and in two of 24 C4-T6 patient ears, P = 0.001. Conclusion: Patients with C2 tetraplegia accumulate more earwax and request its removal more often than patients with lower levels of paralysis.