Katherine Bakes, MD reviewing Ameen ZS et al. J Pediatr 2017 May 1.

More than 260,000 children presented to emergency departments with ear injuries from cotton-tip applicators from 1990 to 2010.

Investigators used the National Electronic Injury Surveillance System database to characterize cotton-tip applicator (CTA)–related injuries among patients younger than 18 years of age who were treated in U.S. hospital emergency departments between 1990 and 2010.

Results were as follows:

• An estimated 263,338 children (mean age, 6 years) were treated for CTA injuries, 99% of which occurred at home.
• Of the 31% of CTA injuries with documented mechanism of injury, 73% were associated with cleaning, 10% with playing, and 9% with a slip or fall.
• The person handling the CTA was the parent in 79% of children <4 years of age and 10% of children 8 to 17 years of age.
• The most common reasons patients with CTA injuries sought care were foreign-body sensation (39%), bleeding (35%), and ear pain (17%).
• 99% of all patients with CTA injuries were treated and released, but the authors note that this does not imply that the injuries were not serious; potential complications include need for surgical repair of the tympanic membrane, ossicular dislocation, perilymphatic fistulas, facial nerve paralysis, hearing loss, and intracranial infections.

CITATION(S):

Ameen ZS et al. Pediatric cotton-tip applicator-related ear injury treated in United States emergency departments, 1990-2010. J Pediatr 2017 May 1; [e-pub].

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