Warmed versus room temperature saline solution for ear irrigation: a randomized clinical trial

Facial nerve palsy as a complication of ear syringing

INTRODUCTION

Syringing of the ear is one of the most common procedures performed for cleaning cerumen from the external auditory canal. Common complications following syringing are pain, external auditory canal trauma and otitis externa. Hearing and vestibular loss have also been reported as complications. However, we are unaware of any report of facial nerve palsy as a complication of ear syringing. Such a case is reported.

CASE PRESENTATION

We describe a case of facial nerve palsy as a complication of syringing, which demonstrates the dramatic presentation of this condition and emphasises the need for great care while syringing the ears.

CONCLUSION

It is important to be aware of this unusual complication with its distinctive presentation. Surgical intervention should be undertaken at the earliest opportunity, for favourable results. A risk-minimising strategy for ear syringing is recommended.

Warmed versus room temperature saline for laceration irrigation: a randomized clinical trial

BACKGROUND

Patient comfort is an important part of laceration repair.

METHODS

The study was a randomized single-blind cross-over trial in which each participant received 250 ml warmed and 250 ml room temperature saline irrigation in simple linear wounds after a local anesthetic was instilled. The solutions and the order of irrigation (warmed first versus second) were separately randomized with a washout period between. Investigators obtaining scores were blinded. Participants determined preferred solution, whether the solution was soothing, and which caused the most discomfort. Participants rated the pain of irrigation using separate Visual Analog Scale scores.

RESULTS

Thirty-eight patients were enrolled in the study. Significantly more preferred warmed to room temperature solutions (difference, 34%; 95% confidence interval, 5.7-63). A Wilcoxon signed-rank test for paired data showed no order effect (P = 0.49) or difference in pain measured according to the Visual Analog Scale (P = 0.082).

CONCLUSION

Warmed saline was more comfortable and soothing than room temperature saline as a wound irrigant among patients with linear lacerations.