103-543: Cotton swabs ( American English ) or cotton buds ( British English ) are wads of cotton wrapped around a short rod made of wood, rolled paper, or plastic . They are most commonly used for ear cleaning, although this is not recommended by physicians. Other uses for cotton swabs include first aid , cosmetics application, cleaning, infant care, and crafts . Some countries have banned the plastic-stemmed versions in favor of biodegradable alternatives over concerns about marine pollution . The first mass-produced cotton swab
206-707: A cot–caught merger , which is rapidly spreading throughout the whole country. However, the South, Inland North, and a Northeastern coastal corridor passing through Rhode Island, New York City, Philadelphia, and Baltimore typically preserve an older cot–caught distinction. For that Northeastern corridor, the realization of the THOUGHT vowel is particularly marked , as depicted in humorous spellings, like in tawk and cawfee ( talk and coffee ), which intend to represent it being tense and diphthongal : [oə] . A split of TRAP into two separate phonemes , using different
309-520: A pronunciations for example in gap [æ] versus gas [eə] , further defines New York City as well as Philadelphia–Baltimore accents. Most Americans preserve all historical /r/ sounds, using what is known as a rhotic accent . The only traditional r -dropping (or non-rhoticity) in regional U.S. accents variably appears today in eastern New England , New York City , and some of the former plantation South primarily among older speakers (and, relatedly, some African-American Vernacular English across
412-489: A Jobson-Horne probe. A postal survey of British general practitioners found that only 19% always performed cerumen removal themselves. It is problematic as the removal of cerumen is not without risk, and physicians and nurses often have inadequate training for removal. Irrigation can be performed at home with proper equipment as long as the person is careful not to irrigate too hard. All other methods should be carried out only by individuals who have been sufficiently trained in
515-430: A bactericidal effect on some strains of bacteria. Cerumen has been found to reduce the viability of a wide range of bacteria, including Haemophilus influenzae , Staphylococcus aureus , and many variants of Escherichia coli , sometimes by as much as 99%. The growth of two fungi commonly present in otomycosis was also significantly inhibited by human cerumen. These antimicrobial properties are due principally to
618-543: A ban between 2019 and 2021. American English American English , sometimes called United States English or U.S. English , is the set of varieties of the English language native to the United States. English is the most widely spoken language in the United States ; the de facto common language used in government, education, and commerce; and an official language in 32 of the 50 U.S. states . Since
721-417: A buildup or blockage of cerumen in the ear canal, which can cause pain, hearing problems, ringing in the ear, or dizziness, and may require medical treatment to resolve. The use of cotton swabs in the ear canal is one of the most common causes of perforated eardrum , a condition which sometimes requires surgery to correct. A 2004 study found that the "use of a cotton-tip applicator to clean the ear seems to be
824-631: A complex phenomenon of "both convergence and divergence": some accents are homogenizing and leveling , while others are diversifying and deviating further away from one another. Having been settled longer than the American West Coast, the East Coast has had more time to develop unique accents, and it currently comprises three or four linguistically significant regions, each of which possesses English varieties both different from each other as well as quite internally diverse: New England ,
927-447: A consonant, such as in pearl , car and fort . Non-rhotic American accents, those that do not pronounce ⟨r⟩ except before a vowel, such as some accents of Eastern New England , New York City , and African-Americans , and a specific few (often older ones) spoken by Southerners , are often quickly noticed by General American listeners and perceived as sounding especially ethnic, regional, or antiquated. Rhoticity
1030-419: A crust, hot oil is poured in, or verdigris mixed with honey or leek juice or a little soda in honey wine . And when the crust has been separated from the ulceration, the ear is irrigated with tepid water, to make it easier for the crusts now disengaged to be withdrawn by the ear scoop . If it is wax, and if it is soft, it can be extracted in the same way by the ear scoop; but if hard, vinegar containing
1133-591: A merger with the THOUGHT ( caught ) set. Having taken place prior to the unrounding of the cot vowel, it results in lengthening and perhaps raising, merging the more recently separated vowel into the THOUGHT vowel in the following environments: before many instances of /f/ , /θ/ , and particularly /s/ (as in Austria, cloth, cost, loss, off, often, etc.), a few instances before /ŋ/ (as in strong, long, wrong ), and variably by region or speaker in gone , on , and certain other words. Unlike American accents,
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#17327934171931236-636: A nice day , for sure); many are now distinctly old-fashioned (swell, groovy). Some English words now in general use, such as hijacking, disc jockey , boost, bulldoze and jazz , originated as American slang. American English has always shown a marked tendency to use words in different parts of speech and nouns are often used as verbs . Examples of nouns that are now also verbs are interview, advocate, vacuum, lobby, pressure, rear-end, transition, feature, profile, hashtag, head, divorce, loan, estimate, X-ray, spearhead, skyrocket, showcase, bad-mouth, vacation , major, and many others. Compounds coined in
1339-440: A paper or plastic sleeve. The advantage of the paper sleeve and the wooden handle is that the package can be autoclaved to be sterilized (plastic sleeves or handles would melt in the autoclave). Cotton swabs manufactured for home use are usually shorter, about 2.5 inches (6.4 cm) long, and usually double-tipped. The handles were first made of wood, then made of rolled paper, which is still most common (although tubular plastic
1442-471: A partnership and purchased from Mrs. Forbis "All merchandise, machinery and fixtures now contained in the premises 132 W. 36th Street and used by said Q-Tips, Inc., for the manufacture of Q-Tips or medicated swabs together with the accounts receivable of said Q-Tips, Inc." The contract recited that Q-Tips, Inc. was the owner of patents covering the manufacture of applicators. Originally, when cotton tipped applicators were made by Mrs. Forbis, they were sold under
1545-433: A perforated eardrum, syringing can force infections into the middle ear, and residual water can cause an infection in the outer ear. This may be effectively accomplished with a spray type ear washer, commonly used in the medical setting or at home, with a bulb syringe . Ear syringing techniques are described in great detail by Wilson & Roeser and Blake et al. who advise pulling the external ear up and back, and aiming
1648-480: A process of extensive dialect mixture and leveling in which English varieties across the colonies became more homogeneous compared with the varieties in Britain. English thus predominated in the colonies even by the end of the 17th century's first immigration of non-English speakers from Western Europe and Africa. Additionally, firsthand descriptions of a fairly uniform American English (particularly in contrast to
1751-680: A series of other vowel shifts in the same region, known by linguists as the " Inland North ". The Inland North shares with the Eastern New England dialect (including Boston accents ) a backer tongue positioning of the GOOSE /u/ vowel (to [u] ) and the MOUTH /aʊ/ vowel (to [ɑʊ~äʊ] ) in comparison to the rest of the country. Ranging from northern New England across the Great Lakes to Minnesota, another Northern regional marker
1854-462: A survey, completed in 2003, polling English speakers across the United States about their specific everyday word choices, hoping to identify regionalisms. The study found that most Americans prefer the term sub for a long sandwich, soda (but pop in the Great Lakes region and generic coke in the South) for a sweet and bubbly soft drink , you or you guys for the plural of you (but y'all in
1957-408: A type of modified sweat gland , and sebum , an oily substance. Both components are made by glands located in the outer ear canal . The chemical composition of earwax includes saturated and unsaturated long chain fatty acids , alcohols, squalene , and cholesterol . Earwax also contains dead skin cells and hair. Excess or compacted cerumen is the buildup of ear wax causing a blockage in
2060-453: A variation of American English in these islands. In 2021, about 245 million Americans, aged 5 or above, spoke English at home: a majority of the United States total population of roughly 330 million people. The United States has never had an official language at the federal level, but English is commonly used at the federal level and in states without an official language. 32 of the 50 states, in some cases as part of what has been called
2163-654: Is also associated with the United States, perhaps mostly in the Midwest and the South. American accents that have not undergone the cot–caught merger (the lexical sets LOT and THOUGHT ) have instead retained a LOT – CLOTH split : a 17th-century distinction in which certain words (labeled as the CLOTH lexical set ) separated away from the LOT set. The split, which has now reversed in most British English, simultaneously shifts this relatively recent CLOTH set into
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#17327934171932266-664: Is also home to a creole language known commonly as Hawaiian Pidgin , and some Hawaii residents speak English with a Pidgin-influenced accent. American English also gave rise to some dialects outside the country, for example, Philippine English , beginning during the American occupation of the Philippines and subsequently the Insular Government of the Philippine Islands ; Thomasites first established
2369-661: Is also used). They are often sold in large quantities, 100 or more to a container. Plastic swab stems exist in a wide variety of colors, such as blue, pink or green. However, the cotton itself is traditionally white. The most common use for cotton swabs is to clean the ear canal by removing earwax . This use is usually against manufacturer instructions. Cotton swabs are also commonly used for cosmetic purposes such as applying and removing makeup and touching up nail polish, as well as for household uses such as cleaning and arts and crafts. Medical-type swabs are often used to take microbiological cultures. The swabs are rubbed onto or into
2472-538: Is common in most American accents despite being now rare in England because, during the 17th-century British colonization, nearly all dialects of English were rhotic, and most North American English simply remained that way. The preservation of rhoticity in North America was also supported by continuing waves of rhotic-accented Scotch-Irish immigrants, most intensely during the 18th century (and moderately during
2575-475: Is gray or tan and brittle, and is about 20% lipid . It has a smaller concentration of lipid and pigment granules than wet earwax. Wet earwax is light brown or dark brown and has a viscous and sticky consistency, and is about 50% lipid. Wet-type earwax is associated with armpit odor , which is increased by sweat production. Some East Asians (including Yamato Japanese), Southeast Asians and Native Americans (including Inuit ) are more likely to have
2678-478: Is immense. Swabs are a primary tool for collecting patient specimens, vital for accurately detecting pathogens, DNA sampling, and disease diagnosis. The collection's precise nature and the swab's quality are critical in ensuring reliable test results. Nasopharyngeal swabs for respiratory virus detection swabs for efficient DNA material collection swabs to assess the presence of microbial infection in sterility and prevention of contamination. The use of cotton swabs in
2781-494: Is known in linguistics as General American ; it covers a fairly uniform accent continuum native to certain regions of the U.S. but especially associated with broadcast mass media and highly educated speech. However, historical and present linguistic evidence does not support the notion of there being one single mainstream American accent . The sound of American English continues to evolve, with some local accents disappearing, but several larger regional accents having emerged in
2884-420: Is often identified by Americans as a "country" accent, and is defined by the /aɪ/ vowel losing its gliding quality : [aː] , the initiation event for a complicated Southern vowel shift, including a " Southern drawl " that makes short front vowels into distinct-sounding gliding vowels . The fronting of the vowels of GOOSE , GOAT , MOUTH , and STRUT tends to also define Southern accents as well as
2987-521: Is the common language at home, in public, and in government. Earwax Earwax , also known by the medical term cerumen , is a waxy substance secreted in the ear canal of humans and other mammals. Earwax can be many colors, including brown, orange, red, yellowish, and gray. Earwax protects the skin of the human ear canal , assists in cleaning and lubrication, and provides protection against bacteria , fungi , particulate matter, and water. Major components of earwax include cerumen , produced by
3090-422: Is the use of swabs for microbiological environmental monitoring . Once taken, the swab can be streaked onto an agar plate, or the contents of the tip removed by agitation or dilution into the broth. The broth can either then be filtered or incubated and examined for microbial growth. Cotton swabs are also often used outside of the field of personal hygiene: The importance of swab technology in medical diagnostics
3193-469: Is the variable fronting of /ɑ/ before /r/ , for example, appearing four times in the stereotypical Boston shibboleth Park the car in Harvard Yard . Several other phenomena serve to distinguish regional U.S. accents. Boston , Pittsburgh , Upper Midwestern , and Western U.S. accents have fully completed a merger of the LOT vowel with the THOUGHT vowel ( /ɑ/ and /ɔ/ , respectively):
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3296-474: Is usually induced by putting objects in the ear in an attempt to remove the wax. A physical exam usually checks for visibility of the tympanic membrane , which can be blocked by excessive cerumen. Impacted cerumen may improve on its own, but treatment by a doctor is generally safe and effective. Hearing usually returns completely after the impacted earwax is removed. Hearing aids may be associated with increased earwax impaction by blocking earwax from leaving
3399-482: The English-only movement , have adopted legislation granting official or co-official status to English. Typically only "English" is specified, not a particular variety like American English. (From 1923 to 1969, the state of Illinois recognized its official language as "American", meaning American English.) Puerto Rico is the largest example of a United States territory in which another language – Spanish –
3502-622: The Mid-Atlantic states (including a New York accent as well as a unique Philadelphia–Baltimore accent ), and the South . As of the 20th century, the middle and eastern Great Lakes area , Chicago being the largest city with these speakers, also ushered in certain unique features, including the fronting of the LOT /ɑ/ vowel in the mouth toward [a] and tensing of the TRAP /æ/ vowel wholesale to [eə] . These sound changes have triggered
3605-551: The Native American languages . Examples of such names are opossum , raccoon , squash , moose (from Algonquian ), wigwam , and moccasin . American English speakers have integrated traditionally non-English terms and expressions into the mainstream cultural lexicon; for instance, en masse , from French ; cookie , from Dutch ; kindergarten from German , and rodeo from Spanish . Landscape features are often loanwords from French or Spanish, and
3708-722: The francophile tastes of the 19th century Victorian era Britain (for example they preferred programme for program , manoeuvre for maneuver , cheque for check , etc.). AmE almost always uses -ize in words like realize . BrE prefers -ise , but also uses -ize on occasion (see: Oxford spelling ). There are a few differences in punctuation rules. British English is more tolerant of run-on sentences , called " comma splices " in American English, and American English prefers that periods and commas be placed inside closing quotation marks even in cases in which British rules would place them outside. American English also favors
3811-436: The skin within the ear canal. The high lipid content of the sebum produced by the sebaceous glands causes the cerumen to work like lubrication . In wet-type cerumen, these lipids include cholesterol , squalene , and many long-chain fatty acids and alcohols . While studies conducted up until the 1960s found little evidence supporting antibacterial activity for cerumen, more recent studies have found that cerumen has
3914-587: The umbo , cells formed in the center of the tympanic membrane move to the walls of the ear canal, and then towards the entrance of the ear canal. The cerumen in the ear canal is also carried outwards, taking with it particulate matter that may have gathered in the canal. Jaw movement dislodges debris from the walls of the ear canal to assist in this process. Removing earwax is in the scope of practice for nurses, audiologists , Family Medicine physicians, and otorhinolaryngologists (ear, nose, and throat doctors). The lubrication provided by cerumen prevents drying of
4017-764: The 18th century; apartment , shanty in the 19th century; project, condominium , townhouse , mobile home in the 20th century; and parts thereof ( driveway , breezeway, backyard ) . Industry and material innovations from the 19th century onwards provide distinctive new words, phrases, and idioms through railroading (see further at rail terminology ) and transportation terminology, ranging from types of roads ( dirt roads , freeways ) to infrastructure ( parking lot , overpass , rest area ), to automotive terminology often now standard in English internationally. Already existing English words—such as store , shop , lumber —underwent shifts in meaning; others remained in
4120-546: The 20th century. The use of English in the United States is a result of British colonization of the Americas . The first wave of English-speaking settlers arrived in North America during the early 17th century, followed by further migrations in the 18th and 19th centuries. During the 17th and 18th centuries, dialects from many different regions of England and the British Isles existed in every American colony, allowing
4223-627: The British form is a back-formation , such as AmE burglarize and BrE burgle (from burglar ). However, while individuals usually use one or the other, both forms will be widely understood and mostly used alongside each other within the two systems. While written American English is largely standardized across the country and spoken American English dialects are highly mutually intelligible, there are still several recognizable regional and ethnic accents and lexical distinctions. The regional sounds of present-day American English are reportedly engaged in
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4326-413: The East Coast (perhaps in imitation of 19th-century London speech), even the East Coast has gradually begun to restore rhoticity, due to it becoming nationally prestigious in the 20th century. The pronunciation of ⟨r⟩ is a postalveolar approximant [ ɹ̠ ] or retroflex approximant [ ɻ ] , but a unique "bunched tongue" variant of the approximant r sound
4429-571: The Inland North. Rather than one particular accent, General American is best defined as an umbrella covering an American accent that does not incorporate features associated with some particular region, ethnicity, or socioeconomic group. Typical General American features include rhoticity , the father–bother merger , Mary–marry–merry merger , pre-nasal "short a " tensing , and other particular vowel sounds . General American features are embraced most by Americans who are highly educated or in
4532-529: The New Zealand claims mentioned above, perforation of the tympanic membrane was by far the most common injury resulting in significant disability. The prevalence of impacted earwax is different across the world. In the United Kingdom 2 to 6% of the population have cerumen that is impacted. In America 3.6% of emergency visits caused by ear issues were due to impacted cerumen. In Brazil 8.4–13.7% of
4635-573: The South), sneakers for athletic shoes (but often tennis shoes outside the Northeast), and shopping cart for a cart used for carrying supermarket goods. American English and British English (BrE) often differ at the levels of phonology, phonetics, vocabulary, and, to a much lesser extent, grammar and orthography. The first large American dictionary, An American Dictionary of the English Language , known as Webster's Dictionary ,
4738-528: The U.S. Several verbs ending in -ize are of U.S. origin; for example, fetishize, prioritize, burglarize, accessorize, weatherize , etc.; and so are some back-formations (locate, fine-tune, curate, donate, emote, upholster and enthuse). Among syntactic constructions that arose are outside of, headed for, meet up with, back of, etc. Americanisms formed by alteration of some existing words include notably pesky, phony, rambunctious, buddy, sundae , skeeter, sashay and kitty-corner. Adjectives that arose in
4841-570: The U.S. are for instance foothill , landslide (in all senses), backdrop , teenager , brainstorm , bandwagon , hitchhike , smalltime, and a huge number of others. Other compound words have been founded based on industrialization and the wave of the automobile: five-passenger car, four-door sedan, two-door sedan, and station-wagon (called an estate car in British English). Some are euphemistic ( human resources , affirmative action , correctional facility ). Many compound nouns have
4944-676: The U.S. are, for example, lengthy, bossy, cute and cutesy, punk (in all senses), sticky (of the weather), through (as in "finished"), and many colloquial forms such as peppy or wacky . A number of words and meanings that originated in Middle English or Early Modern English and that have been in everyday use in the United States have since disappeared in most varieties of British English; some of these have cognates in Lowland Scots . Terms such as fall ("autumn"), faucet ("tap"), diaper ("nappy"; itself unused in
5047-530: The U.S. while changing in Britain. Science, urbanization, and democracy have been important factors in bringing about changes in the written and spoken language of the United States. From the world of business and finance came new terms ( merger , downsize , bottom line ), from sports and gambling terminology came, specific jargon aside, common everyday American idioms, including many idioms related to baseball . The names of some American inventions remained largely confined to North America ( elevator [except in
5150-427: The U.S.), candy ("sweets"), skillet , eyeglasses , and obligate are often regarded as Americanisms. Fall for example came to denote the season in 16th century England, a contraction of Middle English expressions like "fall of the leaf" and "fall of the year." Gotten ( past participle of get ) is often considered to be largely an Americanism. Other words and meanings were brought back to Britain from
5253-597: The U.S., especially in the second half of the 20th century; these include hire ("to employ"), I guess (famously criticized by H. W. Fowler ), baggage , hit (a place), and the adverbs overly and presently ("currently"). Some of these, for example, monkey wrench and wastebasket , originated in 19th century Britain. The adjectives mad meaning "angry", smart meaning "intelligent", and sick meaning "ill" are also more frequent in American (and Irish) English than British English. Linguist Bert Vaux created
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#17327934171935356-540: The United Kingdom reported ear injuries including burns, ear canal occlusions and ear drum perforations and secondary ear canal infections with temporary hearing loss from ear candling. The Food and Drug Administration has taken several regulatory actions against the sale and distribution of ear candles since 1996, including seizing ear candle products and ordering injunctions, and ear candles are now marked as "providing no health benefit". Ear vacuuming Home "ear vacs" were ineffective at removing ear-wax when compared to
5459-474: The United States and the United Kingdom suggest that, while spoken American English deviated away from period British English in many ways, it is conservative in a few other ways, preserving certain features 21st-century British English has since lost. Full rhoticity (or "R-fulness") is typical of American accents, pronouncing the phoneme /r/ (corresponding to the letter ⟨r⟩ ) in all environments, including in syllable-final position or before
5562-605: The West and Midwest, and New York Latino English , spoken in the New York metropolitan area . Additionally, ethnic varieties such as Yeshiva English and " Yinglish " are spoken by some American Orthodox Jews , Cajun Vernacular English by some Cajuns in southern Louisiana , and Pennsylvania Dutch English by some Pennsylvania Dutch people. American Indian Englishes have been documented among diverse Indian tribes. The island state of Hawaii , though primarily English-speaking,
5665-555: The accents spoken in the " Midland ": a vast band of the country that constitutes an intermediate dialect region between the traditional North and South. Western U.S. accents mostly fall under the General American spectrum. Below, ten major American English accents are defined by their particular combinations of certain vowel sounds: In 2010, William Labov noted that Great Lakes, Philadelphia, Pittsburgh, and West Coast accents have undergone "vigorous new sound changes" since
5768-505: The aeronautical sense ], gasoline ) as did certain automotive terms ( truck , trunk ). New foreign loanwords came with 19th and early 20th century European immigration to the U.S.; notably, from Yiddish ( chutzpah , schmooze, bupkis, glitch ) and German ( hamburger , wiener ). A large number of English colloquialisms from various periods are American in origin; some have lost their American flavor (from OK and cool to nerd and 24/7 ), while others have not ( have
5871-574: The basis for the Q Tips packaged sign since that time. The design of the crossed applicators was made by dropping them and then photographing the resulting pattern. The "Q" in Q-Tips stood for "quality", although some believed that it was meant to make it sound like "cute tip". The traditional cotton swab has a single tip on a wooden handle, and these are still often used, especially in medical settings. They are usually relatively long, about 4 inches (10 cm). These often are packaged sterile, one or two to
5974-454: The cotton head may fall off and become lodged in the ear canal. Therefore, cotton swabs should be used only to clean the external ear. Ear candling is a dangerous, ineffective, and counterproductive alternative medicine practice that involves a lighting a hollow candle and placing the unlit end in the ear canal. Advocates say that the dark residue appearing on the candle after the procedure consists of extracted earwax, but studies show that
6077-406: The country), though the vowel-consonant cluster found in "bird", "work", "hurt", "learn", etc. usually retains its r pronunciation, even in these non-rhotic American accents. Non-rhoticity among such speakers is presumed to have arisen from their upper classes' close historical contact with England, imitating London's r -dropping, a feature that has continued to gain prestige throughout England from
6180-614: The diverse regional dialects of British English) became common after the mid-18th century, while at the same time speakers' identification with this new variety increased. Since the 18th century, American English has developed into some new varieties, including regional dialects that retain minor influences from waves of immigrant speakers of diverse languages, primarily European languages. Some racial and regional variation in American English reflects these groups' geographic settlement, their de jure or de facto segregation, and patterns in their resettlement. This can be seen, for example, in
6283-742: The double quotation mark ("like this") over the single ('as here'). Vocabulary differences vary by region. For example, autumn is used more commonly in the United Kingdom, whereas fall is more common in American English. Some other differences include: aerial (United Kingdom) vs. antenna, biscuit (United Kingdom) vs. cookie/cracker, car park (United Kingdom) vs. parking lot, caravan (United Kingdom) vs. trailer, city centre (United Kingdom) vs. downtown, flat (United Kingdom) vs. apartment, fringe (United Kingdom) vs. bangs, and holiday (United Kingdom) vs. vacation. AmE sometimes favors words that are morphologically more complex, whereas BrE uses clipped forms, such as AmE transportation and BrE transport or where
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#17327934171936386-440: The dry type of earwax (gray and flaky), while Africans , Europeans , and other East Asians (including Ainu ) are more likely to have wet type earwax (honey-brown, dark orange to dark-brown and moist). 30–50% of South Asians , Central Asians and Pacific Islanders have the dry type of cerumen. Cleaning of the ear canal occurs as a result of the "conveyor belt" process of epithelial migration, aided by jaw movement. From
6489-440: The ear canal and it can press against the eardrum or block the outside ear canal or hearing aids , potentially causing hearing loss . Cerumen is produced in the cartilaginous outer third portion of the ear canal. It is a mixture of secretions from sebaceous glands and less-viscous ones from modified apocrine sweat glands . The primary components of both wet and dry earwax are shed layers of skin, with, on average, 60% of
6592-438: The ear canal has no associated medical benefits and poses definite medical risks. Cerumen (ear wax) is a naturally occurring, normally extruded , product of the external auditory canal that protects the skin inside the ear, serves beneficial lubrication and cleaning functions, and provides some protection from bacteria, fungi, insects, and water. Attempts to remove cerumen with cotton swabs may result in cerumen impaction ,
6695-412: The ear canal. Earwax can also get into a hearing aid's vents and receivers, and degrades the components inside the hearing aid due to its acidity. Earwax is estimated to be the cause of 60–80% of hearing aid faults. Excessive earwax can also cause tinnitus , a constant ringing in the ears, ear fullness, hearing loss and ear pain. Impacted earwax is more common in those with Down's syndrome , due to
6798-423: The ear, is often faster than irrigation, and is performed with direct vision of the earwax being removed. Typically, a camera with lights and guide hole is utilised, with a long metal vacuum probe being inserted into the guide hole - the practitioner is then able to see inside the ear and remove earwax under pressure. Potential adverse effects include dizziness, temporary tinnitus, and reduced hearing due to volume of
6901-572: The eardrum. Normally, earwax moves toward the opening of the ear and falls out or is washed away, but sometimes excessive earwax can gather and become hard to remove. This is referred to as excessive earwax or impacted cerumen. Excessive earwax may impede the passage of sound in the ear canal, causing mild conductive hearing loss , pain in the ear, itchiness, or dizziness. Untreated impacted wax can result in hearing loss, social withdrawal , poor work function, and mild paranoia . People with impacted wax may also present with perforated eardrums ; this
7004-500: The earwax consisting of keratin , 12–20% saturated and unsaturated long-chain fatty acids, alcohols, squalene and 6–9% cholesterol . There are two genetically -determined types of earwax: the wet type , which is dominant , and the dry type , which is recessive . This distinction is caused by a single base change in the " ATP-binding cassette C11 gene ". Dry-type individuals are homozygous for adenine (AA) whereas wet-type requires at least one guanine (AG or GG). Dry earwax
7107-428: The earwax farther into the ear canal and remove only a small portion of the top layer of wax that happens to adhere to the fibers of the swab. This process is referred to as cerumenolysis . Topical preparations for the removal of earwax may be better than no treatment, and there may not be much difference between types, including water and olive oil. However, there were not enough studies to draw firm conclusions, and
7210-415: The evidence on irrigation and manual removal is equivocal. Commercially or commonly available cerumenolytics include: A cerumenolytic should be used 2–3 times daily for 3–5 days prior to the cerumen extraction. Microsuction involves the use of a vacuum suction probe to break up and extract impacted cerumen. Microsuction can be preferred over other methods as it avoids the presence of moisture in
7313-476: The first commercial producer of cotton tipped applicators was a Mrs. Hazel Tietjen Forbis, who manufactured them in her home. She also owned a patent on the article, numbered 1,652,108, dated December 6, 1927, and sold the product under the appellation Baby Nose-Gay. In 1925, Leo Gerstenzang Co., Inc. purchased an assignment of the product patent from Mrs. Forbis. On January 2, 1937, Q-Tips, Inc's president, Mr. Leo Gerstenzang, and his wife Mrs. Ziuta Gerstenzang formed
7416-517: The following two centuries) when this ethnic group eventually made up one-seventh of the colonial population. Scotch-Irish settlers spread from Delaware and Pennsylvania throughout the larger Mid-Atlantic region, the inland regions of both the South and North, and throughout the West: American dialect areas that were all uninfluenced by upper-class non-rhoticity and that consequently have remained consistently rhotic. While non-rhoticity spread on
7519-944: The hospital , BrE to hospital ; contrast, however, AmE actress Elizabeth Taylor , BrE the actress Elizabeth Taylor ). Often, these differences are a matter of relative preferences rather than absolute rules; and most are not stable since the two varieties are constantly influencing each other, and American English is not a standardized set of dialects. Differences in orthography are also minor. The main differences are that American English usually uses spellings such as flavor for British flavour , fiber for fibre , defense for defence , analyze for analyse , license for licence , catalog for catalogue and traveling for travelling . Noah Webster popularized such spellings in America, but he did not invent most of them. Rather, "he chose already existing options on such grounds as simplicity, analogy or etymology." Other differences are due to
7622-507: The infected area, then wiped across the culture medium , such as an agar plate , where bacteria from the swab may grow. They are also used to take DNA samples, most commonly by scraping cells from the inner cheek in the case of humans. They can be used to apply medicines to a targeted area, to selectively remove substances from a targeted area, or to apply cleaning substances like Betadine . They are also used as an applicator for various cosmetics, ointments, and other substances. A related area
7725-674: The influence of 18th-century Protestant Ulster Scots immigrants (known in the U.S. as the Scotch-Irish ) in Appalachia developing Appalachian English and the 20th-century Great Migration bringing African-American Vernacular English to the Great Lakes urban centers. Any phonologically unmarked North American accent falls under an umbrella known as General American. This section mostly refers to such General American features. Studies on historical usage of English in both
7828-429: The irrigation solution to be warmed to body temperature, as dizziness is a common side effect of ear washing or syringing with fluids that are colder or warmer than body temperature. Earwax can be removed with an ear pick or curette, which physically dislodges the earwax and scoops it out of the ear canal. In the West, use of ear picks is usually only done by health professionals. Curetting earwax using an ear pick
7931-438: The late 18th century onwards, but which has conversely lost prestige in the U.S. since at least the early 20th century. Non-rhoticity makes a word like car sound like cah or source like sauce . New York City and Southern accents are the most prominent regional accents of the country, as well as the most stigmatized and socially disfavored. Southern speech, strongest in southern Appalachia and certain areas of Texas,
8034-412: The late 20th century, American English has become the most influential form of English worldwide. Varieties of American English include many patterns of pronunciation, vocabulary, grammar and particularly spelling that are unified nationwide but distinct from other English dialects around the world. Any American or Canadian accent perceived as lacking noticeably local, ethnic, or cultural markers
8137-515: The leading cause of otitis externa in children and should be avoided." Instead, wiping wax away from the ear with a washcloth after a shower almost completely cleans the outer one-third of the ear canal, where earwax is made. In the US between 1990 and 2010, an estimated 263,338 children went to hospital emergency rooms for cotton swab injuries, accounting for an estimated annual hospitalization of 13,167 children. Plastic cotton swabs are often flushed down
8240-427: The mid-nineteenth century onwards, so they "are now more different from each other than they were 50 or 100 years ago", while other accents, like of New York City and Boston, have remained stable in that same time-frame. However, a General American sound system also has some debated degree of influence nationwide, for example, gradually beginning to oust the regional accent in urban areas of the South and at least some in
8343-401: The most common method of cerumen removal is syringing with warm water. A curette method is more likely to be used by audiologists and otolaryngologists when the ear canal is partially occluded and the material is not adhering to the skin of the ear canal, but due to the high skill level needed to not damage the eardrum, is limited. Cotton swabs are not recommended as they push most of
8446-617: The most formal contexts, and regional accents with the most General American native features include North Midland, Western New England, and Western accents. Although no longer region-specific, African-American Vernacular English , which remains the native variety of most working- and middle-class African Americans , has a close relationship to Southern dialects and has greatly influenced everyday speech of many Americans, including hip hop culture . Hispanic and Latino Americans have also developed native-speaker varieties of English. The best-studied Latino Englishes are Chicano English , spoken in
8549-594: The most widely sold brand name of cotton swabs in North America. The term "Q-tip" is often used as a genericized trademark for a cotton swab in the United States and Canada. The Q-tips brand is owned by Elida Beauty. It was formerly owned by Unilever and had over $ 200 million in US sales in 2014. "Johnson's buds" are made by Johnson & Johnson . However, according to the United States Patent Case (C-10,415) Q-Tips, Inc. v. Johnson & Johnson, 108 F. Supp. 845 (D.N.J. 1952) , it would appear that
8652-622: The name of Baby Nose-Gays. In 1925, after The Leo Gerstenzang Co., Inc. purchased an assignment of the product patent from Mrs. Forbis, the packages of applicators were labelled Baby-Gays. In 1926, the legend was changed to read "Q-Tips Baby Gays", and in 1927 an application was made to register the mark "Q-Tips Baby Gays". Sometime after 1926, the words "Baby Gays" were dropped and the concern began to develop "Q-Tips" as its identifying mark, applying for registration of it on September 14, 1933. Packages were made up using blue paper with pictures of double tipped applicators upon them, features which have been
8755-443: The nozzle of the syringe slightly upwards and backwards so that the water flows as a cascade along the roof of the canal. The irrigation solution flows out of the canal along its floor, taking wax and debris with it. The solution used to irrigate the ear canal is usually warm water, normal saline , sodium bicarbonate solution, or a solution of water and vinegar to help prevent secondary infection. Affected people generally prefer
8858-402: The past forms of a few verbs (for example, AmE/BrE: learned / learnt , burned / burnt , snuck/sneaked , dove/dived ) although the purportedly "British" forms can occasionally be seen in American English writing as well; different prepositions and adverbs in certain contexts (for example, AmE in school, BrE at school ); and whether or not a definite article is used, in very few cases (AmE to
8961-477: The population have impacted cerumen. The treatment of excess ear wax was described by Aulus Cornelius Celsus in De Medicina in the 1st century: When a man is becoming dull of hearing, which happens most often after prolonged headaches, in the first place, the ear itself should be inspected: for there will be found either a crust such as comes upon the surface of ulcerations , or concretions of wax. If
9064-480: The presence of saturated fatty acids, lysozyme and, especially, to the slight acidity of cerumen ( pH typically around 6.1 in average individuals ). Conversely, other research has found that cerumen can support microbial growth and some cerumen samples were found to have bacterial counts as high as 10 /g cerumen. The bacteria were predominantly commensals . Earwax helps protect the ear by trapping dust and other foreign particles that could filter through and damage
9167-407: The procedure. The author Bull advised physicians: "After removal of wax, inspect thoroughly to make sure none remains. This advice might seem superfluous, but is frequently ignored." This was confirmed by Sharp et al., who, in a survey of 320 general practitioners, found that only 68% of doctors inspected the ear canal after syringing to check that the wax was removed. As a result, failure to remove
9270-407: The pump and the proximity of the vacuum probe to the ear drum - the frequency of these are reduced where the cerumen is softened in the five days preceding microsuction. In general, microsuction is well tolerated and even preferred by many patients. Once the cerumen has been softened, it may be removed from the ear canal by irrigation, but the evidence on this practice is ambiguous. If a patient has
9373-422: The same dark residue is left regardless of whether the candle is inserted into an ear, as the residue is derived from the candle itself and not the ear. The American Academy of Otolaryngology states that ear candles are not a safe option for removing ear wax, and that no controlled studies or scientific evidence support their use for ear wax removal. Survey responses from medical specialists (otolaryngologists) in
9476-471: The size and shape of a thick ballpoint pen, combining a miniature digital video camera, LED light source, Wi-Fi connectivity, and various earwax removal attachments. Patients could then connect this electronic curette device to a mobile app on their smartphone and view a real-time video feed of the curette in the ear canal. With practice and careful technique, the device enables patients to inspect their own ear canals and remove excess earwax while also visualizing
9579-407: The smaller, curved shape of the ear canal. Movement of the jaw helps the ears' natural cleaning process. The American Academy of Otolaryngology discourages earwax removal, unless the excess earwax is symptomatic . While a number of methods of earwax removal are effective, their comparative merits have not been determined. A number of softeners are effective; however, if this is not sufficient,
9682-460: The toilet, increasing the risk of marine pollution . Some manufacturers and retailers have stopped the production and sale of plastic swabs and are only selling biodegradable paper versions. The European Union instated a ban on the use of plastic-stemmed cotton swabs in 2021. Italy had previously instated a ban in 2019 and Monaco in 2020. England, Scotland, Wales, and the Isle of Man each instated
9785-587: The total claims received by New Zealand's Accident Compensation Corporation ENT Medical Misadventure Committee. While high, this is not surprising, as ear syringing is an extremely common procedure. Grossan suggested that approximately 150,000 ears are irrigated each week in the United States, and about 40,000 per week in the United Kingdom. Extrapolating from data obtained in Edinburgh, Sharp et al. place this figure much higher, estimating that approximately 7000 ears are syringed per 100,000 population per annum. In
9888-570: The traditional standard accent of (southern) England, Received Pronunciation (RP), has evolved a trap–bath split . Moreover, American accents preserve /h/ at the start of syllables, while perhaps a majority of the regional dialects of England participate in /h/ dropping , particularly in informal contexts. However, General American is also innovative in a number of its own ways: The process of coining new lexical items started as soon as English-speaking British-American colonists began borrowing names for unfamiliar flora, fauna, and topography from
9991-467: The tympanic membrane. However, the risks of accidentally breaking the delicate skin within the ear canal or perforation the eardrum remain concerns. It is generally advised not to use cotton swabs (Q-Tips or cotton buds), as doing so will likely push the wax farther down the ear canal, and if used carelessly, perforate the eardrum . Abrasion of the ear canal, particularly after water has entered from swimming or bathing, can lead to ear infection. Also,
10094-417: The verb-and-preposition combination: stopover, lineup, tryout, spin-off, shootout , holdup, hideout, comeback, makeover , and many more. Some prepositional and phrasal verbs are in fact of American origin ( win out, hold up, back up/off/down/out, face up to and many others). Noun endings such as -ee (retiree), -ery (bakery), -ster (gangster) and -cian (beautician) are also particularly productive in
10197-482: The wax from the canal made up approximately 30% of the complications associated with the procedure. Other complications included otitis externa (swimmer's ear), which involves inflammation or bacterial infection of the external acoustic meatus, as well as pain , vertigo , tinnitus , and perforation of the ear drum. Based on this study, a rate of major complications in 1/1000 ears syringed was suggested. Claims arising from ear syringing mishaps account for about 25% of
10300-775: The word corn , used in England to refer to wheat (or any cereal), came to denote the maize plant, the most important crop in the U.S. Most Mexican Spanish contributions came after the War of 1812 , with the opening of the West, like ranch (now a common house style ). Due to Mexican culinary influence, many Spanish words are incorporated in general use when talking about certain popular dishes: cilantro (instead of coriander), queso, tacos, quesadillas, enchiladas, tostadas, fajitas, burritos, and guacamole. These words usually lack an English equivalent and are found in popular restaurants. New forms of dwelling created new terms ( lot , waterfront) and types of homes like log cabin , adobe in
10403-478: Was common in ancient Europe and is still practised in East Asia . Since the earwax of most Asians is of the dry type, it is extremely easily removed by light scraping with an ear pick, as it simply falls out in large pieces or dry flakes. In the late 2010s, battery-operated 'smart' curette earwax removal devices were introduced to the commercial personal grooming market. These endoscope-like devices are roughly
10506-407: Was developed in 1923 by Polish-American Jew Leo Gerstenzang after he watched his wife attach wads of cotton to toothpicks to clean their infant's ears. His product was originally named "Baby Gays" in recognition of their being intended for infants before being renamed "Q-tips Baby Gays", with the "Q" standing for "quality". The product eventually became known as "Q-tips", which went on to become
10609-469: Was written by Noah Webster in 1828, codifying several of these spellings. Differences in grammar are relatively minor, and do not normally affect mutual intelligibility; these include: typically a lack of differentiation between adjectives and adverbs, employing the equivalent adjectives as adverbs he ran quick / he ran quickly ; different use of some auxiliary verbs ; formal (rather than notional) agreement with collective nouns ; different preferences for
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