title: Magnitude of impacted earwax in Oman, its impact on hearing impairment and economic burden of earwax on health services.
abstract: BACKGROUND
  Wax in ear canal causes a sizeable burden on resources of health services to a country.
  
  
  OBJECTIVE
  The magnitude of impacted wax, its effect in a survey and cost of managing this problem were reviewed in 2002.
  
  
  METHODS
  A study was conducted during 1996 to estimate the magnitude and causes of hearing impairment and ear diseases in Oman. The authors further reviewed the data of community-based prevalence study to assess the role of impacted wax.
  
  
  METHODS
  Trained physicians used portable audiometers to test the hearing status of each ear. They used otoscopes to examine the ear. Persons suspected to have hearing impairment or ear disease were reexamined by audiologists and otologists to determine the causes of hearing impairment. The resources for managing impacted wax were also calculated.
  
  
  RESULTS
  In this survey, 11,402 subjects of all ages were examined. Prevalence of impacted wax was 11.7% (CI 95% 11.1-12.2). Impacted wax was significantly higher in females compared to males [RR = 1.22 (CI 95% 1.10-1.35)]. It was more common in residents of regions with humid environment than those of regions with less humidity [RR = 1.91 (CI 95% 1.67-2.18)]. Impacted wax in ear canal was associated with ear diseases. A total of 181,000 Omani people were estimated to have impacted wax in the ear canal. Managing impacted wax could cost 3.6 million US dollars to the ear care services.
  
  
  CONCLUSIONS
  Impacted wax was a hindrance in the hearing survey and countries should plan to deal with earwax in such surveys. Its impact on hearing impairment and resource burden should be considered while formulating policies for ear care.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery and Communication Disorders, Al Nahdha Hospital, Muscat, Oman.
authors.forename: Mazin
authors.initials: M
authors.lastname: Al Khabori
authors.forename: Subirendra
authors.initials: S
authors.lastname: Kumar
authors.forename: Rajiv
authors.initials: R
authors.lastname: Khandekar
mesh_terms: D000293:Adolescent; D000328:Adult; D001299:Audiometry; D002571:Cerumen; D002648:Child; D002675:Child, Preschool; D004424:Ear Canal / Q000473:pathology*; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006306:Health Surveys; D006311:Hearing Disorders / Q000191:economics / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009850:Oman / Q000453:epidemiology; D038781:Otoscopy; D015995:Prevalence; D012307:Risk Factors