It is
remarkable to see how cultural accepted statements even in 2016 have their
influence on the way we deal with hygienic or medical treatments.
As a Dutch
medical doctor and inventor I was confronted with this phenomenon some years
ago trying to introduce my safe earcleaning device on the UK market.
I found
out there existed in the U.K. a medical
adage” never put anything smaller than an elbow into anyone’s
ear”.
Most
British citizens seemed to be raised-up with this statement not realizing the constraints?
For the
rest of the world and especially Asian people seem to clean and fiddle their
ears themselves with all kind of instruments. But even in British offices one
has to acknowledge there are lots of employees putting paperclips, ballpoints,
matches or hairpins in their ears. So we need a somewhat more scientific
approach to see how small the elbow could be before it might harm the human
eardrum.
This is my story.
About ten years ago one of my patients, who happened to be a
businessman who visited me twice a year to get his ears cleansed from excessive
earwax, asked me; “doctor, is there any safe and effective way to clean my ears
myself? Something similar like dental cleaning? Nothing wrong with consulting
you, but if I could do it myself I would save time and money”.
This question was the trigger to think about another underlying
question: is ear cleaning really a medical treatment or is it more a personal
hygienic action? And if ear cleaning is a personal hygienic action, is it
possible to develop a safe and effective earcleaning device? So I started to do
research to get the right data to solve these questions. I will give you the
results of my survey. About 3 to 6 % of adults seem to have problems with excessive earwax
production. And if earcleaning is truly a medical treatment, you can estimate
the amount of consultatation and money that is involved.
Now to develop a safe earcleaning device for people to clean their
ears themselves I needed the dimensions of the ear canal. First of all the length of the ear canal. A survey on anatomic textbooks and the internet showed
an average length of 25 millimetres. However I could not find how they came to
these conclusions. The anatomic departments got their data from corpses. These
data from the anatomic departments showed a length between 23 and 30
millimetres. Another interesting source for this data was the department of human science of TNO
Soesterberg. They had to measure the length of the ear canal of jet-fighter
pilots alloyed at the local military airbase. This was with a millimetre lined
horsehair. The sign of irritation from the eardrum indicated the length of the
ear canal. The overall results showed
that the length of the ear canal is always longer than
23 millimetres.
So security calculations determine that if I
could design a curette with a stop at about 20 millimetres, it would be
impossible to hit the eardrum. But, what
had to be the safe dimensions of this stop? I needed to know the diameters of
the so called external auditory meatus, which is the oval entrance of the ear canal. Groeneveld–Elcea,
an ear moulding company, provided me
with 186 otoplasties from both adult men and woman, donated by. We measured all
the diameters of the impressions of entrance of the earcanal. It found out that the maximum length of the
small diameter of the oval entrance we could find was 11.5 millimetre.
So a spherical shape of
the stop from 15 millimetres should prevent the curette going to deep into the ear
canal. And so my safe earcleaning device was born called "earpal". Being part of the E.U. I
needed a CE mark to prove my ear cleaning device was safe enough to let the
Europeans clean their ears themselves.
The notified body
appointed by Brussels agreed with the CE mark and I even got a patent for my
‘earpal’.
Another fixed idea
concerning earwax is that earwax is weakened best with oil. But at the
University of Leiden doctor dr. Just Eekhof discovered that water is the most
quick and easiest way to weaken earwax as published in the British Journal of
General Practice.
After having sold about
350.000 earpals I came to the conclusion that there is scientifically spoken not
much difference between ears of different nations in Europe, but there is still
a cultural difference the way we look at, or medically spoken, in peoples ears.
Cors Ephraïm, general
practitioner
However, to generate an estimate of the numbers of people in the general
population with earwax that potentially may be problematic (‘impacted’ or ‘occluding’), these estimates have been applied to the UK population
size.
An estimate of
the prevalence in adults (aged 16–59 years) based on a figure of 2–5%9,21,22 and
a UK adult population of 36,122,100 (taken from mid-2006 estimates27) suggests somewhere between
722,000 and 1,800,000 adults may have in UK problematic earwax.
Taking a range of 10–43%9,23 in children aged less
than 16 years and a UK
child population of 11,537,100,27 the range ofthe
prevalence of potentially problematic earwax would be in the region of
1,154,000–4,961,000.
In those older than 60 years there may be somewhere between 2,069,000 and
7,369,000 people with potentially
problematic earwax (based on a range of 16–57%9,24,26 and a population of
12,928,10027
