I recently wrote about not using cotton ear swabs in children and since then, an even more unsettling study on injuries caused by these swabs was recently published online in the Journal of Pediatrics.

Nationwide Children's Hospital researchers found that over a 21-year period from 1990 through 2010, an estimated 263,000 children younger than 18 years of age were treated in U.S. hospital emergency departments for cotton tip applicator related ear injuries. This is about 12,500 annually or about 34 injuries every day.

Most of the injuries occurred when the child was using the cotton tip applicator to try to clean the ear, followed by injuries that happened when a parent or sibling used the cotton tip applicator on the child's ear. About two out of every three patients were younger than 8, with patients aged 0-3 years accounting for 40 percent of all injuries.

And it should be noted: this is a low estimate because it does not include injuries taken to doctor's offices, free standing rapid care facilities, or not treated at all.

"The two biggest misconceptions I hear as an otolaryngologist are that the ear canals need to be cleaned in the home setting, and that cotton tip applicators should be used to clean them; both of those are incorrect," said Kris Jatana, MD, senior author of the study from Nationwide Children's Hospital in a statement. "The ear canals are usually self-cleaning. Using cotton tip applicators to clean the ear canal not only pushes wax closer to the ear drum, but there is a significant risk of causing minor to severe injury to the ear."

Again, do not put anything into your child's ears ever!