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|EAR CLEANINGS AND CERUMEN MANAGEMENT|
What is earwax and why is it a problem? It is normal for the skin in the ear canal to replenish, thereby cleaning itself by moving toward the outer opening of the ear canal. It mixes with cerumen glands in the outer one-third, breaks up and normally falls out. The mixture is called cerumen or earwax. A little earwax is fine and actually has helpful medicinal qualities as it traps sand or dust particles before they reach the ear drum. It also protects the outer part of the ear canal because it repels water, however, when cerumen abnormally accummulates rather than falling out, it can potentially interfere with sound reaching the eardrum.
Cerumen problems affect between 2%-6% of the general population in the United States. As the older cerumen reaches the opening of the ear, it usually dries out and falls away. It is estimated 150,000 a week have their ears cleaned because of wax blockage.
Most audiologists have not been trained to use a binocular microscope (otomicroscopy); therefore, they use either a hand-held otoscope or video-otoscope. They may attempt to remove cerumen in this manner, but this limits their ability to remove cerumen as safely and comfortably when compared to using an otomicroscope.
NOTE: Pre-pandemic pictures shown below
Examples of manual removal using currettes and lavage (water). In our office, the patient is able to watch the process. While it would seem this is unnecessary or difficult for the patient, the fact is that it is helpful to both patient and clinician. Rarely do patients prefer not observe the procedure.
Manual removal of cerumen
Lavage with water going into basin
Tympanometry to verify normal eardrum mobility - only possible when earwax has been successfully excavated
Clinician and assistant completing lavage on the right ear
Tympanometry to verify successful removal of earwax and normal eardrum functional. This patient noticed immediate iimprovement in hearing following the procedure. He has been coming to me for the past 10 years.