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 Discomfort Tinnitus occasionally
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