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BestBETs Use of olive oil for ear wax

BestBETs Use of olive oil for ear wax. Nick Jones & Kat Young. Forming a clinical question. P opulation Adults (>18 yrs ) presenting with symptomatic ear wax I ntervention Use of olive oil drops C omparator Use of alternative ear wax solvent or no treatment O utcome

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BestBETs Use of olive oil for ear wax

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  1. BestBETsUse of olive oil for ear wax Nick Jones & Kat Young

  2. Forming a clinical question • Population • Adults (>18 yrs) presenting with symptomatic ear wax • Intervention • Use of olive oil drops • Comparator • Use of alternative ear wax solvent or no treatment • Outcome • Removal of ear wax, with or without syringing

  3. Three part question In {an adult with symptomatic ear wax} are {olive oil ear drops} best at {removing wax and facilitating syringing} ?

  4. Clinical scenario A 40 year old man presents to his GP with a sensation of bilateral blocked hearing, tinnitus and itching. Examination reveals hard wax obscuring the auditory canal and tympanic membrane. The gentleman asks if olive oil drops are the best first option and whether they need to be used in conjunction with syringing to be effective?

  5. Search strategy PubMed, Embase & Medline search using strategy: [exp ear wax OR cerumen] AND [olive oil] LIMIT to human and English language

  6. Results 26 papers 3 systematic reviews or meta-analysis 21 irrelevant or in vitro 2 relevant RCTs ??Eekhof paper 1 controlled clinical trial

  7. Results

  8. Results

  9. Results

  10. Results

  11. Conclusion • The evidence for the use of olive oil is weak and some of the in vitro studies suggest that it is ineffective alone in cerumenolysis. • It does however seem to be equally effective to other topical solvents in providing a slight advantage over no treatment in facilitating successful syringing. • There is a lack of any recent, well-designed, large scale randomised control trials in this area, a point recognised by the three previous systematic reviews.

  12. Bottom line There is no evidence that olive oil offers a significant benefit over other topical treatments for ear wax but given its safety and cost is a reasonable first line treatment, particularly if used in conjunction with subsequent syringing.

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