Ear Wax

Ear wax is also called cerumen. It is normally produced in small amounts in the external ear canal. It is created from a combination of secretions, dead skin cells and any substances that enter the ear. Ear wax has a protective effect, helping to prevent infection in the ear canal. In most people, ear wax does not cause any problems.

 

Impacted Ear Wax

Ear wax can build up and become impacted and stuck to the tympanic membrane. This can result in:

  • Conductive hearing loss 
  • Discomfort in the ear
  • A feeling of fullness
  • Pain
  • Tinnitus

 

Ear wax can be seen on examination with an otoscope. It may completely cover the tympanic membrane, preventing assessment of the tympanic membrane and inner ear. 

 

Management

In most cases, ear wax does not require any interventions. The ears should naturally regulate the amount of wax in the ear canal without any issues.

Inserting cotton buds into the ear should be avoided, as this can press the wax in further and cause impaction.

There are three main methods for removing ear wax:

  • Ear drops – usually olive oil or sodium bicarbonate 5%
  • Ear irrigation – squirting water in the ears to clean away the wax
  • Microsuction – using a tiny suction device to suck out the wax

 

Ear drops may be enough to clear the ears. If not, ear irrigation can often be performed in primary care. Where there are contraindications to ear irrigation (e.g., perforated tympanic membrane or infection), microsuction can be performed by specialist ear, nose and throat services.

 

Last updated July 2021
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