title: Ear wax.
abstract: BACKGROUND
  Ear wax only becomes a problem if it causes a hearing impairment or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when normal extrusion is prevented--for example, by the use of hearing aids, or by the use of cotton buds to clean the ears. Ear wax can visually obscure the ear drum, and may need to be removed for diagnostic purposes.
  
  
  METHODS
  We conducted a systematic review and aimed to answer the following clinical question: What are the effects of methods to remove ear wax? We searched: Medline, Embase, The Cochrane Library and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  
  
  RESULTS
  We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
  
  
  CONCLUSIONS
  In this systematic review we present information relating to the effectiveness and safety of the following interventions: ear syringing, manual removal (other than ear syringing), and wax softeners (alone or prior to syringing).
authors.affiliation: MRC Institute of Hearing Research, Glasgow, UK.
authors.forename: George G G
authors.initials: GG
authors.lastname: Browning
mesh_terms: D000287:Administration, Topical; D002571:Cerumen / Q000187:drug effects; D034381:Hearing Loss; D006801:Humans; D015994:Incidence; D007507:Therapeutic Irrigation; D016896:Treatment Outcome