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Impacted earwax

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VOL: 100, ISSUE: 29, PAGE NO: 30


- The skin cells lining the outer ear canals include tiny glands, similar to sweat glands, which produce the wax (cerumen).



- The wax slowly works its way to the outside, taking trapped dirt and dust with it.



- Most people’s ears clear the wax as fast as it is produced but if it builds up it can cause problems.



- Impacted wax in the ears is a common cause of deafness, discomfort, and sometimes noises in the ears.



- Earwax can be a potential source of transmission of hepatitis B (Kalcioglu et al, 2004).



- Impacted earwax is common.



- It is one of the most common causes of hearing loss.



- Just under one-third of older people experience the problem.



- In the UK thousands of people every week have earwax removed. The chances of wax accumulating are increased by use of hearing aids and cotton buds.



- Wax may be produced in increased quantities that the ear is unable to clear. Persistent exposure to loud noise can induce this response as can a viral infection.



- Ear canals can be narrow or lie at an angle. This can slow the natural passage of the wax leading to a build-up.



- Increased difficulty in hearing.



- Pain in either or both ears.



- Hearing a noise or a ringing.



- An awareness of something blocking up the ear’s canal or a feeling of fullness.



- Temporary deafness or pain in the ear(s) after swimming or having a bath or shower (because water causes the plug of wax to swell).



- Hearing loss.



- Earache.



- Itchiness in the ear.



- Reflex cough.



- Dizziness or vertigo.



- Tinnitus.



- Some people are asymptomatic.



Earwax can be removed in a number of different ways:



- Wax softeners such as olive oil or over-the-counter proprietary brands are often effective;



- Irrigation or syringing using an electric jet irrigator is the most common procedure;



- Mechanical methods such as suction, using probes, or forceps with direct vision.



- Past or present perforation of the ear drum.



- Ear infection.



- Presence of a grommet.



- History of ear surgery.



- Patients who are unable to cooperate such as young children or those who are confused.



Adverse effects are common and can include:



- Perforation of the ear drum;



- Damage to the external canal;



- Pain;



- Deafness;



- Vertigo.



Aung, T., Mulley, G.P. (2002)
10-minute consultation: removal of ear wax. British Medical Journal; 325: 27.



For information on earwax removal for parents of young children: dony79enc_earwax



NHS Direct’s health encyclopaedia:

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