Publication:

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

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.