1. Impacted wax

3. 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.

4. 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.

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

6. 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

7. 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

8. 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.

9. 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.