Why poking cotton bud in the ear can make you deaf

Dar es Salaam. For weeks, James Chuwa, 35, had been experiencing a debilitating ringing sound in his right ear, prompting him to visit an ear specialist at Muhimbili National Hospital (MNH) in Dar es Salaam. Chuwa made the visit to the specialist to figure out the problem.
“The doctor held my face up and carefully inserted an otoscope (an instrument designed to visually examine the inner ear) into my left ear. He went on to the right one. Then, he pulled the gadget out quickly, looked at me and asked, “Have you been using cotton bud to clean your ears? “I admitted”, recalls Chuwa. That happened last year.
Chuwa says that he used to buy bundles of cotton buds from the supermarket—which he kept at his home—and was routinely using them to clean his ears every time he took a shower.
Just two days before the onset of the ear problem, Chuwa says he had intensely cleansed both his ears using the cotton buds. “The doctor told me that the cotton bud had lodged in my ear after examining me,’’ he says in an interview with Your Health.
 “That day when I went to the hospital with troubles in my ear, the doctor strongly warned me against using the cotton buds. He told me that I was damaging my ears,’’ says the resident of Tabata Kimanga in the city.
“I stopped that habit right away and I have not suffered the same problem again,’’ he adds.
Chuwa is not alone; almost each day, many people enter supermarkets and one of the things they purchase, are the little padded sticks—the cotton buds. They are marketed as household staples and used for various kinds of beauty upkeep.
Nadia Mohammed, 25, a third year student at the University of Dar es Salaam (UDSM), says she always feels uncomfortable when she doesn’t remove the wax in her ears.
“I actually bought a bundle of the cotton buds from a pharmacy close to our hostels in Mabibo. I usually feel like my ears are not clean if I don’t remove that sticky substance that usually develops in the ears’’ she says. She adds “My friends use cotton buds to do the same.”  
A specialist on Ear, Nose and Throat diseases (ENT), Dr Edwine Liyombo from MNH, says that the use of cotton buds or swab means that people like Chuwa and Nadia face the risk of being deaf or suffering from a wide range of ear infections.
“Patients visit this ENT clinic with ear infections and most times when I ask them whether they were cleaning their ears, most of them report to have been using cotton buds or cotton swabs,’’ says Dr Liyombo.
“They are not supposed to clean the ears,’’ says the Head of ENT at MNH. He tells Your Health that people who clean their ears by using the cotton buds, are of various categories.
“There are patients with some forms of ear allergies and those with persistent fungal infection in their ears. These are some of the categories of people with the tendency of using the cotton buds more frequently,’’ he says.
“There are those who even poke their pen or pencils into the ears to remove wax or scratch themselves. They can twist them in their ears simply because it feels great to do that,’’ he says.
Ms Shamim Ally*, a journalist with a local newspaper, says that she ensures her dressing table at home in Mbagala suburb has bundles and bundles of the cotton buds.
“One reason I like them is because of that sensation that I feel when I place them in my ears. I didn’t buy them for that reason but I’m sort of addicted to the feeling too,’’ says Shamim.
Medical sources show that ears are naturally filled with sensitive nerve endings, which send signals to various other parts of our bodies when triggered.
When someone tickles the insides of the ear by using the cotton buds, this triggers pleasure in the entire ear.
Dermatologists usually refer to the pleasure as the itch-scratch-cycle and it’s addictive in nature. It may also be psychologically tempting for people to keep using the cotton buds.
But in so doing, Dr Liyombo, says, people usually disrupt the natural mechanism of the ear, which was made to trap the dust, bacteria and all other forms of infections that the ears are exposed to.
There are no studies done in Tanzania yet to ascertain the extent of the problem but, according to Dr Liyombo, a number of patients have been found to damage their ears through inserting some items in the ears.
“You see, when a person inserts the tip of a pen or pencil, it can damage the surface of the ear-drum. The membrane forming the eardrum is very delicate. In that case, this can affect the way sound is transmitted in the ear,’’ he says.
He advises people not to worry about the wax that develops in the outer ear canal.
“That wax which develops in the ear canal can fill and the excess be removed naturally. People tend to think that they have to remove the wax,’’ explains the ENT Surgeon.
One may ask, why do people remove the ear wax anyway, and, how does anyone clean their ears without a cotton bud?
The ear wax—scientifically known as cerumen—has antibacterial and antifungal properties. It protects the skin of the ear canal from dryness. “It’s the ear’s natural cleaner,’’ says Dr Liyombo.
According to medical sources, the ear wax naturally migrates within the ear and can naturally move through the outer edge of the ear and the amount of wax in the ear varies person to person.
“People, especially the youth, who constantly walk around with headphones, can block the wax and it can build up in the ear,’’ Dr Liyombo says further in the interview.
A medical doctor at AAR Clinic in Dar es Salaam, Dr Ivone Mwakasege says that she has been advising her patients not to poke any items—such as pins, pen or pencils into their ears.
When someone has a problem with the ear or they have an itching sensation, they can place their finger on the outer skin above the pinna of the ear, but not actually inserting their finder in the ear canal, she says.
“If symptoms persist, it’s always advisable to see a doctor in the nearby clinic or make an appointment with an ear, nose and throat specialist,” she adds.
There are, however, people who complain that the wax in their ears may over-flow in the outer-ear canals. Some studies have indicated that there are factors which can lead to the build-up of the wax in the ears.
Beyond the long-term use of headphones, excessive hair in the ear, narrow ear canals, bony growths and swimming in cold water may impair the wax migration process, shows one study.
It was published in 2008, by the American Academy of Otolaryngology who issued the first comprehensive clinical guidelines for assessment, management, and treatment of impacted earwax.

According to healtylivin.com, people who have heavy wax build-up, a trip to the doctor may be needed. “Doctors can easily remove it with a little peroxide mixed with water and injected into the ear,’’ reads the website editorial.
The process is virtually painless and is very effective in removing impacted wax. If this frequently becomes a problem, patients can ask their physicians for directions to do the procedure at home, it reads further.
It gives a list of items that are not to be poked into the ears—such as, cotton buds, hair pins, tweezers, straws and paper clips.