Much to the disappointment of many in the world, humanity is still dealing with the impact COVID-19 is having on the way we live our lives. As we continue to social distance and restrict our out-of-home activities to as little as simply acquiring groceries, we exacerbate a myriad of psychological and physical side-effects that extend beyond the risk of contracting the virus. It is true that many hearing health care practices in the United States have crafted both innovative and extraordinary ways to continue to treat people with hearing issues as we try to carry on within the boundaries of this contagious new reality. But, as we have done so, we have also identified new issues that our patients are confronting as a result of their virus mitigation efforts.
Prior to the onset of COVID-19, it had been estimated that approximately 850 million people worldwide experienced complete occlusion of their ear-canal approximately every three months due to excessive cerumen. Now that stay-at-home patients are regaining some access to professional hearing care, patients seeking treatment for excessive cerumen is exploding. One hearing care professional describes current trends as a “tsunami of cerumen”. Google searches using ear wax-related terms are up 5000% compared to pre-pandemic trends. All of this is likely the direct result of the interruption to regular hearing health care access the pandemic has fostered.
Excessive cerumen not only can contribute to a loss of hearing, its presence can complicate or even confound efforts to treat other more permanent aspects of hearing loss. As a result, when a hearing care professional encounters a patient with excessive cerumen, the first order of the day must be to remove it. For some hearing health professionals, this may entail referring the patient to another provider. And, data suggests that this referral process alone can significantly reduce the likelihood that the patient will return to the original hearing health professional for continued care. For other providers, the wax removal process becomes the next step in their treatment of that patient – a step that may take time and introduce the potential for re-scheduling the patient for the treatment they originally expected to receive. In addition, all re-usable equipment employed for cerumen extraction must be sterilized and decontaminated prior to its safe use with the next cerumen-challenged patient. This is especially important since recent evidence suggests that cerumen may be a source of COVID-19 spreads.1 With COVID-19 significantly expanding the need for such treatment, these time and procedural issues represent a new challenge for the hearing care practitioner.
In a recent online survey conducted by AUDNET Hearing Group, collected data indicated that only 17% of the respondents (all in private practice) who provide cerumen removal services do so using disposable devices. This means that for 83% of the procedures, inter-patient sterilization and decontamination protocols are required. In addition, the survey found that only 1% of the respondents indicated that they use a disposable technology purposely designed to significantly reduce the time involved in effective cerumen removal.
Since 2014, EarWays Medical (a company located within the thriving Israeli life sciences community) has been researching, producing and ultimately distributing an innovative cerumen removal technology called “EarWay Pro”. This, single-use cerumen extraction device consists of a flexible helix (corkscrew) styled and open profiled tip that, when rotated inward into the ear canal, can effectively encapsulate and collect cerumen for extraction as a single cluster. It enables expedient extraction of cerumen impaction quickly, effectively, and hygienically with no need for a subsequent sterilization/decontamination effort. See procedural video HERE.
Prior to the pandemic reaching the United Sates, AUDNET Hearing Group organized a clinical field trial of the EarWay Pro device with several private practice clinics across the country participating. Of the twenty-one ears that were treated using the device, it took on average less than one minute per ear to remove excessive earwax and gain sufficient visualization of the tympanic membrane to proceed with the next phase of testing/treatment. Participating clinicians judged the procedure as both very effective and very safe.
In a recent webinar, Alicia Spoor, Au.D., owner of Designer Audiology and past-president of the Academy of Doctors of Audiology (ADA), acknowledges a learning curve with the product. Once sufficient proficiency and comfort using the product is achieved, she reports great satisfaction and success in being able to remove cerumen quickly and effectively, and finds this technology useful in delivering cerumen removal services, especially in a COVID environment.
Since FDA approval of the EarWay Pro in December of 2019, the product has been steadily gaining traction as an effective and useful clinical tool in the U.S. Considering the effectiveness of this procedure in significantly reducing the amount of time needed to remove excessive ear wax, eliminating the need for inter-patient sterilization procedures, and recognizing the potential “tsunami” of cerumen extraction need fostered by months of social distancing, it seems reasonable to encourage all hearing health care professionals in the Unites States to explore the use of this technology in their clinical practice. To assist, AUDNET Hearing Group will be conducting its second webinar detailing the EarWay Pro product and procedures March 24, 2021 at 12:00 pm EST. For more information about this webinar, visit the AUDNET Hearing Group Blog.
References:
- Hanege et al (2020). SARS-CoV-2 presence in saliva, tears, and cerumen of COVID-19 patients. Laryngoscope, October 23, 2020. www. onlinelibrary.wiley.com/doi/10.1002/lary.29218
David J. Smriga is an audiologist and Vice-President of Corporate Communications for AUDNET Hearing Group, a national organization that provides business, marketing and buying support services for independent hearing care practices. As well as positions in both clinical and research audiology, Mr. Smriga has held senior management positions in sales, marketing product management and public relations for some of the industries top manufacturing firms. Since 2002, Mr. Smriga has also been Senior Audiology Consultant for Audioscan, a premier manufacturer of real-ear measurement and hearing aid verification test equipment.
