Healthy Ears and Earwax

Cerumenor earwax is a self-cleaning agent produced in your ears with protective, lubricating, and antibacterial properties.

Earwax is not really a "wax" but a water-soluble mixture of secretions, plus hair and dead skin. Earwax is formed in the outer one-third of the ear canal, but not in the deep part of the ear canal near the eardrum.

The absence of earwax may result in dry, itchy ears. Most of the time the ear canals are self-cleaning; that is, there is a slow and orderly migration of earwax and skin cells from the eardrum to the ear opening.

Old earwax is constantly being transported, assisted by chewing and jaw motion, from the ear canal to the ear opening where it usually dries, flakes, and falls out.

Dr Wendy Stern of Northeast Ear Nose and Throat reminds us that many people mistakenly believe that earwax should be routinely removed for personal hygiene. This is not so. In fact, attempting to remove earwax with cotton-tipped swabs, bobby pins, or other probing devices can result in damage to the ear, including trauma, impaction of the earwax, or even temporary deafness. These objects only push the wax in deeper, and can block the ear canal entirely.

Under ideal circumstances, the ear canals should never have to be cleaned. However, that is not always the case. Your doctor should clean the ears when enough earwax accumulates to cause symptoms or to prevent a needed assessment of the ear.

This condition is called cerumen impaction, and may cause one or more of the following symptoms:

• Earache, fullness in the ear, or a sensationthe ear is plugged
• Partial hearing loss, which may be progressive
• Tinnitus, ringing, or noises in the ear
• Itching, odor, or discharge
• Coughing

If you or a child is experiencing any of these symptoms, you should seek the care of a medical professional to confirm that earwax is the cause. Do not attempt to remove the wax yourself. An otolaryngologist is a medical doctor who specifically deals with conditions of the ears and is trained to treat such a problem. For patients who wear hearing aids, special attention must be paid to make sure earwax does not damage the aid or impair function. Cerumen in the ear canal can cause the hearing aid to fit poorly and not seal properly. If the hearing aid fits poorly, sound produced by the aid passes around it and out of the ear canal, where it is picked up by the microphone and reamplified. A positive feedback loop is created and audible, high-pitched feedback results.

Cerumen removal eliminates feedback, when the feedback is due to excess cerumen. Too much earwax can also damage the listening device. In fact, current estimates from various hearing aid manufacturers indicate that 60 to 70 percent of all hearing aids sent for repair are damaged as a result of contact with cerumen. Patients who wear hearing aids should have their otolaryngologist examine the ears for impacted cerumen during a routine healthcare visits. Examination is accomplished by removing the hearing-aid and inspecting the ear canal with a handheld otoscope. If your doctor finds evidence of earwax impaction, he or she may need to perform a variety of techniques to help remove the obstruction.

These include:

• Flushing the ear with cerumenolytic (wax-dissolving) agents, which include water, saline, and other agents of comparable efficacy.
• Using irrigation or ear syringing.
• Manual removal with special instruments or a suction device, which is preferred for patients with narrow ear canals, eardrum perforation or tube, or immune deficiency.

DO

• Understand that earwax is a natural, self-cleaning agent that should not be regularly removed unless it is causing a health problem.
• Use a warm, moist washcloth to clean the outside of your ears, but never insert anything into your ear canal.
• Try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops in the ear to moisten the earwax and let it naturally work its way out of the ear.
• See an otolaryngologist (ENT doctor) if you believe you have discharge, fullness, ear pain, reduced hearing, or other persistent ear symptoms.
• Ask your otolaryngologist about recommended methods of removing excess earwax, which include irrigation (syringing), wax-dissolving eardrops, and manual cleaning with a microscope and specialized instruments.

DON'T

—Never insert anything into your ear canal, regardless of its size

or shape. This includes things like cotton-tipped swabs, pens, hair

pins, etc.

• Never use an "ear candle" to help remove earwax. An ear candle is a 10" to 15"-long, cone-shaped, hollow candle, typically made of wax-impregnated cloth. Ear candles have been proven ineffective for earwax and may cause burns to the face and hair, obstruction of the ear canal with wax of the candle, or perforation of the membrane that separates the ear canal and the middle ear.
• Do not use any type of irrigation device by yourself. These include items like water picks designed for use in the mouth, or a bulb syringe.

Don't ignore the following symptoms:

• Earache, fullness in the ear, or a sensation the ear is plugged
• Partial hearing loss, which may be progressive
• Tinnitus, ringing, or noises in the ear
• Itching, odor, or discharge
• Coughing