Rosh Emergency Medicine Practice Test

What is a possible risk of using cotton swabs for ear cleaning, as demonstrated in a patient with ear pain and discharge?

1. Eardrum perforation

2. Earwax impaction

3. External otitis

4. Mastoiditis

The correct answer is: External otitis

Using cotton swabs for ear cleaning poses various risks, with one significant concern being the potential for external otitis. When cotton swabs are inserted into the ear canal, they can inadvertently push earwax deeper, creating a blockage or impaction. This trapped wax can lead to irritation and inflammation of the ear canal, which may develop into external otitis, commonly known as swimmer's ear. This condition is characterized by pain, redness, and discharge. The act of cleaning the ear canal with cotton swabs may also disrupt the natural defense mechanisms of the skin in the ear canal, making it more susceptible to infection. The introduction of foreign objects, such as cotton swabs, can also introduce bacteria and exacerbate inflammation, leading to symptoms like ear pain and discharge. While perforation of the eardrum, earwax impaction, and mastoiditis are important considerations related to ear health, they do not directly correspond to the consequences of cotton swab use in the same way external otitis does, particularly in terms of inflammation of the ear canal due to inappropriate cleaning methods.