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Cerumen Prop

Dr. Tolkha Amaruddin, M.Kes, SpTHT

RSUD SARAS HUSADA PURWOREJO 2008

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Definition Cerumen prop : obstruction of the

EAC by cerumen The term cerumen earwax Cerumen the secretory product

of the ceruminous glands in the EAC, it’s just one component of earwax

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Physiology

Ear wax : mixture of secretions of the ceruminose & pilosebaseus glands, squames of epithelium, dust & other foreign debris located in the cartilaginous portion of the ears canal. Protection acid condition : PH 6 Transport of debris Lubricant Bactericid efect

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Different types of cerumen

Cerumen : dry or wet, soft or hard

DRY - HARDWET - SOFT

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Pathophysiology

Its quantity varies individually & its consistency is determined by proportions of mixture

In a normal condition cerumen can migrate from canalis auditory external in flake by open the mouth and mastication

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Cause of obstruction : 1. Over production2. Dry type wax3. Malformation of the external

auditory canal (anatomic)4. Cleaning the ear inappropriatly

push the cerumen posteriorly impaction

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Symtomps : Hearing impairment (deafness)

CHL Earache Reflex cough Fullness in the ear Tinitus – vertigo

ObjectiveFinding the cerumen in the canalis

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Treatment

1. Ceruminolytics Epithelial acumulation desquamation &

debris collection. A ceruminolytic disrupt the structural

integrity of the keratin sheets and thereby soften, loosen, liquefy, &/ dissolve cerumen and perhaps even float it out.

The integrity of the cell membrane ▼, which allows water to pass into the corneocytes along an osmotic gradient.

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2. Technique Instrumentation2.1. Syringing2.2. Suction2.3. Hooking under direct vision.

A careful history: tympanic membrane perforation previous ear surgery

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Education

Do not to attempt self removal of cerumen with the use of any devices such of: cutton bud, and hairpins:

1. Increase impaction 2. Secondary infection

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Cerumen Prop vs Keratosis Obturans

Cerumen Prop Keratosis Obturans

Definition Obstruction of EAC keratolitic mass of by cerumen desquamating squamous epitheliumLocation Cartilage Portion Bony PortionAetiology Over production Probably related to of cerumen faulty migration of squamous epithelial cellsSymptom obstructed pain, otorrhoea

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