Preventing and treating ear wax build-up:
Latest guidelines issued from American Academy of Otolaryngology 2017
Ear wax, also called cerumen, is a substance naturally produced by the body to clean, provide a thin protective barrier, and lubricate the ears. Without your wax, the ears would be dry itchy and prone to infection. Although cerumen(wax) is essential for ear health, too much of the waxy substance can cause a number of problems, such as earache partial hearing loss, tinnitus(ringing), itching and coughing.
It is estimated that approximately one in 10 children and one in 20 adults experience excessive buildup of wax.
Unfortunately, certain cleaning practices actually contribute to the problem. This includes the use of cotton swabs, paper clips, toothpicks and ear candling- all of which can create abrasions, punctures and gently push the wax deeper and contribute to further impaction in the canal. This additionally can cause significant damage to the eardrum itself which may be temporary or permanent in some cases.
The use of earbuds or hearing aids can potentially further compact existing wax over time.
Swimming can also cause retained moisture behind significant wax accumulation and contribute to increase risk of canal infection.
Additional risk factors are individuals with narrowed width canals, excessively hairy ear canals, dry skin conditions such as eczema, and lupus or Sjogren’s syndrome.
An individual that has wax problems should not try to remove it themselves, but rather seek medical assistance.
A medical professional will examine patient’s ears using a handheld otoscope or magnified otomicroscope. There are variations of color, consistency, and textures of wax. Some types fall out on its own, and others require assistance.
Commercially available ear drops (Debrox) can soften the wax making it much easier & and less uncomfortable to remove in a longstanding or dense impaction situation.
Warm water irrigation may be used to flush wax out , however it is often uncomfortable and messy.
And there is potential risk of damage, or creation of infection if the removal is unsuccessful and moisture is retained.
At The Ear Nose & Throat Institute we prefer to remove wax with a gentle suction device and may use additional handheld instruments, such as a loop curette(spoon) or thin hook to reach behind the wax and gently pull it forward.
Irrigation is not recommended in patients who have undergone prior ear surgery within 12 months or if there is an existing tympanostomy ear tube, blockage with other foreign body, history of cleft palate or history of eardrum perforation or recent known ear infection.
Additionally, patients with prior vertigo or pain should not undergo irrigation.
We are often questioned about the use of ear candling to remove wax.
This technique has been evaluated repeatedly, and has been debunked. It is not considered a successful, nor even safe technique to attempt wax removal. There has been evidence of ear candling resulting in burns or blockage of the ear and even rupture of the eardrum.
Vertigo is a possible, yet uncommon, earwax complication, but has been known to occur when there is a dense impaction pushing against the eardrum.