title: Cotton-tip applicators as a leading cause of otitis externa.
abstract: OBJECTIVE
  Otitis externa (OE), also known as "swimmer's ear", is an inflammation or infection of the external auditory canal. Many risk factors have been identified, mainly excessive moisture in the canal from swimming.
  
  
  METHODS
  To study the leading risk factors of otitis externa. Eighty-seven children aged 3.5-12 years (mean 68+/-6.5 months) who were diagnosed with otitis externa from December 1999 to March 2001 were studied for age, sex, cerumen cleaning habits, signs and symptoms. Findings were compared to an age-matched control group of 90 children without otitis externa.
  
  
  RESULTS
  Sixty-one children (70.1%) in the study group had their ears cleaned with a cotton-tip applicator (Q-tip) during the 10 days preceding the diagnosis of otitis externa. In the control group, only 31 (34%) used applicators routinely during the 10 days prior to diagnosis (P<0.001). Other risk factors for otitis externa were swimming in a pool (34%), wax removal (5.8%) and ventilation tubes (1.1%).
  
  
  CONCLUSIONS
  Use of a cotton-tip applicator to clean the ear seems to be the leading cause of otitis externa in children and should be avoided.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva 49202, Israel. nussim@clalit.org.il
authors.forename: Moshe
authors.initials: M
authors.lastname: Nussinovitch
authors.forename: Ayelet
authors.initials: A
authors.lastname: Rimon
authors.forename: Benjamin
authors.initials: B
authors.lastname: Volovitz
authors.forename: Eyal
authors.initials: E
authors.lastname: Raveh
authors.forename: Dario
authors.initials: D
authors.lastname: Prais
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
mesh_terms: D016022:Case-Control Studies; D002571:Cerumen; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010032:Otitis Externa / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors