A comparative study of sodium bicarbonate 5% and carbamide peroxide 6.5% as cerumenolytic agents

Younus Majeed Dar; Majid Ul Islam Masoodi; Viqar Khursheed Mir

doi:10.18203/issn.2454-5929.ijohns20253386

Authors

Younus Majeed Dar Department of ENT and HNS, SKIMS Medical College, Bemina, Srinagar, Jammu and Kashmir, India
Majid Ul Islam Masoodi Department of ENT and HNS, SKIMS Medical College, Bemina, Srinagar, Jammu and Kashmir, India
Viqar Khursheed Mir Department of ENT and HNS, SKIMS Medical College, Bemina, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20253386

Keywords:

Cerumen, Earwax, Sodium bicarbonate, Carbamide peroxide, Cerumenolytic agents

Abstract

Background: Earwax impaction is common and can cause symptoms such as hearing loss, discomfort, tinnitus, vertigo, and chronic cough. Removing impacted cerumen often improves hearing. Many cerumen-removal products exist but have limited efficacy, often requiring multiple doses over days. Sodium bicarbonate (5%) and carbamide peroxide (6.5%) are two important cerumenolytics. This study aimed to compare their effects on different degrees of wax obstruction.

Methods: This cross-sectional study at a tertiary ENT center included 148 adult patients with ≥50% bilateral ear canal occlusion (grades 3-4). Each patient received 5% sodium bicarbonate drops in one ear and 6.5% carbamide peroxide drops in the other, three times daily for four days. After 4 days, cerumen was removed by syringing and clearance outcomes were compared. Data were analyzed statistically with significance at p≤0.05.

Results: The mean age was 54±12.8 years, with a male predominance. Hearing loss was the most common symptom. Sodium bicarbonate demonstrated significantly more effective cerumen dissolution and clearance than carbamide peroxide (p<0.05). Complete clearance was achieved in 34.3% and 25.0% of ears treated with sodium bicarbonate and carbamide peroxide, respectively. Nearly half of sodium bicarbonate-treated ears (50.5%) were cleared with one syringing attempt, compared to about one-third with carbamide peroxide.

Conclusions: Sodium bicarbonate is a more effective option than carbamide peroxide for treating cerumen impaction in the external ear canal. By reducing blockage and symptoms, its use can improve patients’ quality of life.

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