Cerumen Impaction

(Earwax; Ear Impaction; Ear Blockage)
  • Definition

    Cerumen is the soft yellow wax secreted by glands in your ear canal. It is more commonly known as earwax. Cerumen impaction occurs when earwax becomes wedged in and blocks the ear canal.
    The Ear Canal
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  • Causes

    Cerumen impaction is usually caused by:
    • An inability of the ear to naturally clear itself of cerumen
    • Putting objects into your ears that push the cerumen deeper into the ear canal
  • Risk Factors

    Factors that increase your risk of getting cerumen impactation include:
    • Trying to remove cerumen with a cotton-tipped swab.
    • A twisted, narrow, or complicated ear canal
    • Ears that overproduce cerumen
    • Age: affects the elderly and causes hearing loss
    • Dense hair growth in ear canal
    • Hearing aid use
    • Intellectual disability
  • Symptoms

    Symptoms may include:
    • Itchy ear
    • Pain in the ear
    • Ringing in the ear
    • Hearing loss
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. An ear exam will be done to look for impacted cerumen.
  • Treatment

    Treatment involves removal of the earwax from the ear canal. Talk with your doctor about the best treatment plan for you. Cerumen can be removed by:
    • Your doctor 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.
    • Flushing—Your doctor may rinse the impacted cerumen using flushing equipment.
    • 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.
    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 swimmer’s ear —an infection or inflammation of the skin that lines the ear canal
    • Injure the ear canal
    • Cause the cerumen to become more impacted and more difficult to remove
    If you are diagnosed with cerumen impaction, follow your doctor's instructions .
  • 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.
    • Use medications as advised by your doctor to help prevent the build up of earwax.
    • If you are concerned about earwax, see your doctor. Do not attempt to remove the earwax by yourself.
    • Schedule regular visits to remove earwax build up as advised by your doctor.
  • RESOURCES

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

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

    CANADIAN RESOURCES

    Canadian Society of Otolaryngology http://www.entcanada.org

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

    References

    Cerumen impaction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated October 30, 2012. Accessed September 13, 2013.

    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).

    2/26/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Ear candles: risk of serious injuries. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201108.htm . Published February 20, 2010. Accessed February 26, 2010.

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