RESUMO
BACKGROUND: Wax in ear canal causes a sizeable burden on resources of health services to a country. AIM: The magnitude of impacted wax, its effect in a survey and cost of managing this problem were reviewed in 2002. SETTINGS AND DESIGNS: A study was conducted during 1996 to estimate the magnitude and causes of hearing impairment and ear diseases in Oman. The authors further reviewed the data of community-based prevalence study to assess the role of impacted wax. MATERIALS AND METHODS: Trained physicians used portable audiometers to test the hearing status of each ear. They used otoscopes to examine the ear. Persons suspected to have hearing impairment or ear disease were reexamined by audiologists and otologists to determine the causes of hearing impairment. The resources for managing impacted wax were also calculated. RESULTS: In this survey, 11,402 subjects of all ages were examined. Prevalence of impacted wax was 11.7% (CI 95% 11.1-12.2). Impacted wax was significantly higher in females compared to males [RR = 1.22 (CI 95% 1.10-1.35)]. It was more common in residents of regions with humid environment than those of regions with less humidity [RR = 1.91 (CI 95% 1.67-2.18)]. Impacted wax in ear canal was associated with ear diseases. A total of 181,000 Omani people were estimated to have impacted wax in the ear canal. Managing impacted wax could cost 3.6 million US dollars to the ear care services. CONCLUSIONS: Impacted wax was a hindrance in the hearing survey and countries should plan to deal with earwax in such surveys. Its impact on hearing impairment and resource burden should be considered while formulating policies for ear care.