Ear Wax

1
Ear Wax

• Lawrence Pike

2
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.

3
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

4
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.

5
Self Care

• Assess if
• Child
• Pain
• Discharge from the ear
• Known perforation of the eardrum
• Previous mastoid surgery

6
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.
• There is some suggestion that sodium bicarbonate
  may be particularly 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.

7
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

8
Ear Syringing

• Ear syringing has been shown 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