# A Novel Earwax Self-Sampling Device: A Feasibility Study
## 4 Discussion  
We found that the self-sampling earwax device obtained more earwax than one commonly used clinical syringing method. Our results showed that the amount of obtained earwax was greater at follow up in both ear sides after the baseline extraction. Regardless of the sampling method used, and the amount of earwax, the obtained volume in relation to the mean, varied little among participants. Most participants considered that the self-sampling earwax device to be comfortable, effective and safe. They also reported that its use felt safer, more effective and as comfortable as the use of \"cotton buds\". It is noticeable that irrespective of the sampling method used, the amount of extracted earwax increased significantly during the follow-up period. This might indicate that the ceruminous glands of the external ear canal increased their earwax production, possibly as a compensatory mechanism, due to the removal of earwax that the baseline cleaning procedure caused. However, this difference may also be explained by our study protocol. We instructed participants to avoid cleaning their external ears during the follow-up period to obtain a standardised amount of earwax that could represent the retrospective month of earwax production. This possibility was reinforced after observing that before of the study period, 36% of our participants were \"heavy\" cotton swab users, and another 29.6% least sporadically used them (Table 3). It is also possible that the baseline cleaning loosened some earwax, entailing that the follow up clinical procedure was then more efficient at sampling earwax. The syringing method obtained more than a double amount of earwax (4.7 \(\pm\) 2.8 mg/week) than the most effective cleaning method used by [PERSON] et al. (1986) when they used an unspecified mechanical method, syringing one mixed solution of alcohol/ether 3:1 _v/v_ (2.02 \(\pm\) 0.22 mg/week) in healthy participants. It is quite likely than our considerably larger sample may have explained this result. We replicated the finding of no difference in earwax volume between different ear sides, as also found by [PERSON] et al. (1990). Figure 3: Vectors of Sample Relative Dispersion [VSRS], rather than the Vectors of Sample’s Squared Relative Dispersion [VSSRS] were graphed for a better conception of data dispersion. _p_-values were obtained comparing the Coefficient of Dispersions of each sample. The self-sampling earwax device obtained greater than eight times the amount of secretion than the syringe. It is not completely clear why this novel device showed this considerable improvement in earwax sampling in comparison to the clinical method. This might be explained by the design of the syringe intended to extract impacted earwax. Thus, the clinical method removal effect appears to be related to the volume, rather than the weight of earwax, since both follow-up samples increased, rather than decreased their mass. The clinical method removal effect, influenced by the pressure exerted by warm water, may not be appropriate for sampling thin layers of oily secretion from healthy ears, irrespective of their weight. The most recently secreted earwax may likely be tightly adhered to the external auditory canal epidermis, due to its oily, rather than waxy features. By contrast, we previously conducted a preclinical pilot study that showed that the tip material of this novel device was effective at removing artificial wax from a piece of animal skin. These results made us predict that the self-sampling earwax device may be useful for this feasibility study. In addition to this, we incorporated into the tip of the device a mineral oil solution that has shown some effect at cleaning earwax [10]. The cumulative effect of the tip material (an absorptive and abrasive sponge) and the oily solution may explain its superior effectiveness at earwax sampling in healthy ears. One potential limitation of this study is that while the clinical method requires to dry the earwax samples before analysis, this step was not needed when the novel device was used.