[Complication rate of out-patient removal of ear wax: systematic review of the literature].
BACKGROUND
Cerumen impaction is known as a frequent problem both in general practice as well as in community based ENT surgeries. The aim of the present review was to describe the frequency and types of complications due to different methods of ear wax removal.


METHODS
A systematic review of the literature was carried out (Pubmed, Cochrane, Scopus) and data from the arbitration board for medical liability were evaluated.


RESULTS
Controlled studies addressing the complications of ear wax removal are lacking in the literature and absolute risks could not be reported. Perforation of the tympanic membrane was observed in up to 1% of the cases. Syringing seems to result in a greater number of complications than mechanical removal using a curette.


CONCLUSIONS
Complication rates were found to be higher than previously assumed. However, none of the publications had initially been intended to detect adverse events. It can be concluded that syringing can be delegated to trained staff members only if pre-existing defects of the tympanic membrane have been excluded.
Schmiemann
G
G
Institut für Allgemeinmedizin, OE5440, Medizinische Hochschule Hannover, Hannover, Germany. schmiemann.guido@mh-hannover.de
Kruschinski
C
C
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002571:Cerumen; D015897:Comorbidity; D034381:Hearing Loss / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data*; D018058:Tympanic Membrane Perforation / Q000453:epidemiology* / Q000517:prevention & control*