Banji's test: A new diagnostic test of ear wax impaction

BACKGROUND: Impaction is a major clinical criterion for the treatment of ear wax. In this paper, a new diagnostic test of ear wax impaction is described with a view to improve the diagnostic accuracy of ear wax impaction. METHODS: Patients with or without impaction of their ear wax were examined with the Banji's test. The test consists of a pull on the pinna and a response to sound perception. A sudden, momentary increase in sound perception following the pull is considered positive and indicates impaction. A negative response is when there is no increase in sound perception and is non-specific. RESULTS: In all, 165 patients aged 10 to 43 years were studied. Of this, 60 (36.4%) had bilateral while 105 (63.6%) had unilateral ear wax, giving a total of 225 ears with the condition. Of the 225 ears, 132 had impaction while 93 had no impaction. Banji's test was positive in 121 and negative in 11 ears with impaction, while it was positive in 12 and negative in 81 ears without impaction. This gives a sensitivity of 91.7% and specificity of 87.1%. There was a strong correlation between the Banji's test and clinical criteria for impaction. CONCLUSION: With a sensitivity of 91.7%, Banji's test can accurately diagnose ear wax impaction. A positive test is predictive that removal of the ear wax will significantly relieve the patient of auditory symptoms. The test is simple, harmless, and can discriminate between wax and other causes of otological symptoms.