2IntroductionEar Wax (Cerumen) is a natural protective oily substance which is produced in the outer third of the ear canalIts function is to remove small foreign particles, such as dust, from the canalThis is achieved by the ciliary hairs.
3Symptoms Diminished hearing Discomfort Tinnitus occasionally often of sudden onset after “cleaning” the earsDiscomfortseldom complain of pain unless the wax is pressing on the drumTinnitus occasionally
4Educational PointsWax is a normal physiological substance which has an important role in protecting the ear canalThe 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.
5Self Care Assess if: Child Pain Discharge from the ear Known perforation of the eardrumPrevious mastoid surgery
6Self CareEar 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.
7Primary Care Treatment In more severe cases use of a ceruminolytic ear drop for 4 to 5 days prior to syringing is advisableRemoval with wax hook is also an option
8Ear SyringingEar syringing has been shown to improve hearing in those with impacted waxThe lowest pressure possible should be used.It is best avoided ifthe eardrum is known or suspected to be perforatedthere is a history of mastoid surgery or chronic middle ear diseaseIf patient has unilateral deafnessA history of recurrent otitis externa or tinnitus