Impacted Wax

Introduction

• Ear Wax (Cerumen) is a natural protective oily substance which is produced in the outer third of the ear canal.

• Its function is to remove small foreign particles, such as dust, from the canal.

• This is achieved by the ciliary hairs.

Definition

• Excess collection of thick ear wax is known as impacted wax.

Impacted Wax

Symptoms

• Diminished hearing– often of sudden onset after “cleaning”

the ears• Discomfort

– seldom complain of pain unless the wax is pressing on the drum

• Tinnitus occasionally

Educational Points

Wax is a normal physiological substance which has an important role in protecting the ear canal

The ear canal is a self-cleaning system, do not to use cotton buds as wax is more likely to be pushed back against the eardrum and become impacted.

Ear wax only needs to be removed if it causes symptoms or if a proper view of the eardrum is needed.

Primary Care Treatment

• In more severe cases use of a ceruminolytic ear drop for 4 to 5 days prior to syringing is advisable

• Removal with wax hook is also an option

Formby cerumen hook and scoop

Self Care

Ear drops to soften ear wax (ceruminolytics) may be used as the only treatment in mild cases.

There are many different preparations on the market, none with any clear clinical advantage compared to the others.

Sodium bicarbonate may be effective at disintegrating ear wax.

A simple home remedy is olive oil, warmed by pouring onto a warm spoon.

Preparations containing organic solvents are particularly likely to cause irritation and inflammation of the external ear canal and should be avoided.

Ear Irrigation

• Ear irrigation to improve hearing in those with impacted wax

• The lowest pressure possible should be used.

• It is best avoided if– the eardrum is known or suspected to be

perforated– there is a history of mastoid surgery or chronic

middle ear disease– If patient has unilateral deafness– A history of recurrent otitis externa or tinnitus

Ear irrigation syringe

Ear irrigation

The End