Impacted wax

Ear wax (cerumen) – yellowish waxy substance secreted in the ear canal It protects the skin of the ear canal, assist in cleaning, lubrication and antibacterial effects Excess cerumen can press against the eardrum or occlude (block) the external auditory canal or hearing aids, potentially hindering hearing.

Causes In older persons – earwax becomes dense and drier Hair becomes thicker and coarse – entrapping the hard dry cerumen in the canal Water that enter the canal during a shower or swimming may cause swelling of the cerumen resulting in blockage of the canal.

Signs and symptoms Partial hearing loss Hearing aids malfunction due to increased ear wax impaction Otalgia Tinnitus Vertigo Feeling of fullness in the ear

Cerumen is a viscous secretion which contains shed layers of skin, keratin, fatty acids and cholesterol Two forms – dry type and wet type Wet type is dominant and dry type is recessive Asians and native Americans – gray and flaky African and European – brown and dark brown

Cleaning effect Cleaning of the ear canal occurs as a result of epithelial migration aided by jaw movement Along with the wax, debris and other unwanted particles is been carried towards outward of the ears

Treatment Ear wax removal is discouraged unless excess earwax is causing health problems Ear Syringing or irrigation Wax softners – cerumenolytics Suction Instrumentation -Curette method Cotton swabs – push most of the earwax into the ear canal and remove only a small portion of the wax and also adhere the fibers.

Softeners Cerumenolysis Topical preparations to remove ear wax Cerumenolytics are oil,and glycerine, Sodium bicarbonate in water, olive oil Cerumol (turpentine and dichlorobenzene) Docusate, emulsifuying agent Should be used 2-3 times (1-2 drops) daily for 3 – 5 days prior to the cerumen extraction.