title: Effectiveness of ear syringing in general practice: a randomised controlled trial and patients' experiences.
abstract: BACKGROUND
  Ear syringing is a common procedure performed for a variety of symptoms in primary care. Reports of its effectiveness vary considerably and no randomised controlled trials (RCTs) have been performed.
  
  
  OBJECTIVE
  To estimate the effect of ear syringing on hearing thresholds and on symptoms leading to ear syringing in general practice.
  
  
  METHODS
  Randomised single-blind controlled trial. Before-and-after self-assessments of symptoms.
  
  
  METHODS
  Patients from three general practices in the Bristol area attending twice-weekly clinics dedicated to ear syringing over a 12-week period.
  
  
  METHODS
  Patients were randomly assigned to have their hearing tested before and after ear syringing, or twice before ear syringing. Changes in hearing threshold were measured by pure tone audiometry (PTA). All patients completed sef-assessment forms of symptoms using Likert scales before, and one week after, ear syringing.
  
  
  RESULTS
  Hearing threshold improved by 10 dB or more in 34% (95% confidence interval [CI] = 21% to 47%) of the intervention group and 1.6% of control group (number needed to treat = 3.1, 95% CI = 2.2 to 5.2, P<0.001). The levels of improvement in the intervention group ranged between 15 dB and 36 dB. The symptoms that most commonly improved included hearing on the phone, pain, a feeling of blocked ears, and hearing one-to-one. There was a strong relationship between the change thresholds, as measure using PTA, and self-reports of hearing improvement. Secondary analysis was unable to identify predictors of objectively measured improvement.
  
  
  CONCLUSIONS
  Ear syringing improved hearing threshold in a substantial proportion of patients. An even larger proportion reported an improvement in symptoms. It was not possible to predict which patients would benefit.
authors.affiliation: Air Balloon Surgery, St George, Bristol. dmemel@airballoon.cix.co.uk
authors.forename: David
authors.initials: D
authors.lastname: Memel
authors.forename: Carole
authors.initials: C
authors.lastname: Langley
authors.forename: Chris
authors.initials: C
authors.lastname: Watkins
authors.forename: Barbara
authors.initials: B
authors.lastname: Laue
authors.forename: Martin
authors.initials: M
authors.lastname: Birchall
authors.forename: Max
authors.initials: M
authors.lastname: Bachmann
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D002571:Cerumen; D004739:England; D005194:Family Practice / Q000592:standards; D005260:Female; D034381:Hearing Loss / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013594:Syringes; D007507:Therapeutic Irrigation; D016896:Treatment Outcome