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Cerumen Impaction
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Cerumen Impaction

(Earwax; Ear Impaction; Ear Blockage)

Pronounced: suh-ROO-men im-PAK-shon

En Español (Spanish Version)

Definition

Cerumen is the soft yellow wax secreted by glands in your ear canal, more commonly known as earwax. Cerumen impaction occurs when earwax becomes wedged in (impacted) and blocks the ear canal.

Cerumen or earwax has many useful purposes. One of the main uses is that it protects against infection. It helps fight bacterial ear infections and protects the inside of your ear.

Earwax moves out of your ear naturally. Earwax should not be removed by you. In fact, continuously trying to clean your ear of cerumen by using a cotton swab, for example, can damage your ear. By trying to remove earwax, you can:

  • Damage your eardrum (the membrane that vibrates and transmits sound to the middle ear)
  • Make yourself more prone to ear infections
  • Make yourself more prone to swimmer’s ear (an infection of the skin that lines the ear canal)
  • Injure the ear canal
  • May cause the cerumen to become more impacted and more difficult to remove

The Ear Canal

si55550929_96472_1_with ear wax

© 2008 Nucleus Medical Art, Inc.

It is important to prevent cerumen impaction before it happens because it has been found to cause hearing loss .

This condition can be treated; contact your doctor if you think you may have cerumen impaction.

Causes

Cerumen impaction is usually caused by inability of the ear to naturally clear itself, and unsuccessful attempts to remove earwax. By inserting a cotton-tipped swab into your ear, you actually jam the more solid part of the earwax deeper into your ear. Your ear has a harder time trying to get rid of this harder, bulkier wax, and the impaction or blockage begins.

Factors that contribute to cerumen impaction include:

  • Trying to remove cerumen with a cotton-tipped swab
  • Putting objects into your ears that may push the cerumen in the ear canal deeper

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing cerumen impaction:

  • Individuals who obsessively try to clean their ears and try to remove the wax
  • A twisted, narrow, or complicated ear canal
  • Ears that overproduce cerumen
  • Age: affects the elderly and causes hearing loss
  • Mental retardation

Symptoms

If you experience any of these symptoms, do not assume it is due to cerumen impaction. These symptoms may be caused by other, less or more serious health conditions. If you experience any one of them, see your physician.

Symptoms include:

  • Itchy ear
  • Pain in the ear
  • Tinnitus (ringing) in the ear
  • Hearing loss

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. When you go to your doctor, he or she will look into your ear with a special flashlight called an otoscope. Your doctor will look for impacted earwax.

Treatment

Treatment involves removal of the earwax from the ear canal. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Removal of Cerumen by an Instrument

Your doctor can remove cerumen using one of several instruments, including:

  • Curette—This is a surgical instrument shaped like a scoop.
  • Suction—When the cerumen is loosened, the doctor will vacuum the earwax.

Removal of Cerumen by Flushing

Your doctor may rinse the impacted cerumen using flushing equipment.

Removal of Cerumen by Ceruminolytic Agents

Your doctor may prescribe or recommend using a ceruminolytic agent. This is a liquid-like solution that is used to drop into the ear and soften the earwax to help ease removal.

Prevention

To help reduce your chances of getting cerumen impaction, take the following steps:

  • Do not clean your ears with anything more than a soapy washcloth on the outer rim of your ear.
  • Do not use cotton-tipped swabs to clean anywhere inside your ears.
  • If you are concerned about earwax, see your doctor. Do not attempt to remove the earwax by yourself.

RESOURCES:

American Academy of Audiology
http://www.audiology.org

American Academy of Otolaryngology
http://www.entnet.org

American Speech–Language–Hearing Association
http://www.asha.org

CANADIAN RESOURCES:

Canadian Society of Otolaryngology
http://www.csohns.com

Health Canada
http://www.hc-sc.gc.ca

References:

Beers MH, Berkow R, eds. External ear. The Merck Manual of Diagnosis and Therapy . Section 7, Chapter 83. The Merck Manual website. Available at: http://www.merck.com/mrkshared/mmanual/section7/chapter83/83b.jsp . Accessed September 8, 2005.

Jabor MA, Amedee RG. Cerumen impaction. J La State Med Soc. 1997;149:358-362.

Mahoney DF. Cerumen impaction. Prevalence and detection in nursing homes. J Gerontol Nurs. 1993;19:23-30.

Olusanya BO. Hearing impairment in children with impacted cerumen. Ann Trop Paediatr. 2003;23:121-128.

Pray WS, Pray JJ. Earwax: Should it be removed? US Pharmacist. 2005;30(5).

Wax blockage. University of Maryland–Medical Center website. Available at: http://www.umm.edu/ency/article/000979.htm . Accessed September 8, 2005.



Last reviewed January 2008 by Elie Edmond Rebeiz, MD, FACS

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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