Cerumen is also known as earwax, a substance in normal quantities is healthy. The function includes a self-cleaning agent, lubrication, and antibacterial properties. Most ear canals are self-cleaning (slow and orderly migration of earwax and skin cells deep near the ear drum, out to the ear canal opening). Earwax is typically not formed in the deep part of the ear canal but may be inadvertently pushed from the outer one-third of the ear canal.
Normally, the ear canals should never have to be cleaned due to their self-cleaning properties. However, if enough earwax accumulates to cause symptoms or prevent medical evaluation ear, cleaning may be required. To clean the ears, one should wash only the external ear with a damp cloth, but nothing should be inserted mechanically into the ear canal (old saying; nothing bigger than your elbow in your ear!).
Home treatments may be effective to soften wax and facilitate the self-cleaning properties. This may include mineral oil, baby oil, glycerin, or commercial drops (e.g., Debrox) into the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide may also aid in the removal of wax.
Irrigation is commonly performed by a primary care physician, or sometimes at home. It is important to warm the irrigant to body temperature to prevent severe dizziness.
Manual removal of earwax is the gold standard for removal of moderate to severe wax impactions. This is performed under a microscope evaluation by the Otolaryngologist at Sonoran Ear Nose and Throat. This is especially important with cleaning of ears that have narrow/tortuous ear canals, an eardrum with a perforation or tube, other methods have failed, or with diabetes/weakened immune system.
Cotton Swabs (Q-tips) are prohibited in our ears.
Cotton swabs should never be used in or around the ear canal, as most cleaning attempts tend to push the wax deeper into the ear canal, causing a blockage and associated symptoms.
Prevention of Excessive Earwax
There are no proven ways to prevent cerumen impaction, however, if you are prone to repeated wax impaction (including use of hearing aids) it is recommended to seek Otolaryngology evaluation for serial ear cleaning under microscopy, typically every 6 to 12 months, and evaluation of general ear health.
Ear Fluid (a.k.a., Otitis Media)
The Eustachian tube is the connection between the nose and ear. When the Eustachian tube is blocked whether it be due to inflammation during a cold, allergy, or upper respiratory infection, this leads to a build-up of pus or fluid behind the eardrum. This is what is called acute otitis media. Symptoms can include pain, swelling, and redness, and sensation of hearing problems/plugging, and crackling/popping sensation.