In the study, Study: Cotton swabs prove problematic for ear health, a strong and direct correlation between ear drum punctures and cotton swab use was observed.
But can you really blame the cotton swab? Perhaps we just need better education in its use.
I've always been told not to shove those things in my ear, and only use them to clean the outside region of the ear, not the ear canal.
Just saying...
But at the same time, a ruptured ear drum can be serious, so be careful with cotton swabs and get medical attention immediately.
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