Audiology
Cerumen Impaction
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Cerumen impaction is the blockage of the outer ear canal by tightly packed cerumen, also called earwax. Cerumen is the yellowish oily substance produced in the outer ear canal, the tube from the opening of your ear to the eardrum. A wet cerumen is sticky and brownish in color, while a dry cerumen is crusty and greyish. Cerumen helps clean out dead skin cells and prevents dirt and water from entering the inner ear. Cerumen may also protect the ear from bacteria and fungi. Normally, cerumen flows outward to the opening of the ear where it falls out or gets washed away. Cerumen impaction happens when the wax dries, builds up and gets stuck along the ear canal.

Causes

Anything that affects the normal outward flow of cerumen may cause impaction. Cerumen impaction may be more common in men, the elderly and in people with mental health problems. It is not a sign that a person is not clean. The following factors may make earwax more likely to become impacted:

  • Advanced age, when the ears tend to make drier cerumen
  • Conditions that produce too much cerumen, such as keratosis and other skin diseases
  • Narrow or abnormally shaped ear canals
  • Wearing a hearing aid
  • Incorrect use of cotton swabs, or using needles, hair pins or other objects to clean the ears

Signs and symptoms

You may have any of the following:

  • Trouble hearing
  • Dizziness
  • Ear fullness or a feeling that something is plugging up your ear
  • Itchiness or pain in the ears
  • Ringing in the ears

Diagnosing

Your doctor will take a detailed history from you. This includes any ear problems or procedures you may have had. Your doctor will carefully check your ears using an otoscope and a good light. An otoscope is an instrument used to better see the inside of the ears. Your doctor may look for other problems, such as bleeding, infection or injury. Your eardrums will be checked for tears or holes. Your doctor may also order a hearing test.

Treatment

Treatment for a cerumen impaction is mainly to remove the hardened wax. The type of treatment to be used may depend on the patient's age, symptoms or risk factors. Ask your doctor which of the following treatments may be best for you:

  • Wax softeners: Eardrops that are water-based or oil-based may be used to clear or soften the impacted earwax. This may be used alone or in combination with a procedure to remove the earwax.
  • Procedures: When the impaction can be clearly seen, removal may be done using any of the following:
    • Irrigation: Water that is body temperature is used to wash the wax out of the ear canal. Irrigation may not be used on people with an eardrum tear or infection, or who have had ear surgery.
    • Suction: A machine that sucks the object out of the ear canal may be used to remove small formed cerumen plugs. This procedure uses a small plastic tube that goes in the ear and is connected to the machine.
    • Instruments: A curette (scoop-like instrument) or forceps (grasping instrument) may be used to remove the impacted cerumen.

With treatment, the cerumen impaction may be removed from the ear and more serious problems prevented.

Health risks

Untreated impacted cerumen may cause your symptoms to become worse. If it is not removed, it may cause an infection, irritation or further ear problems. Removal of impacted cerumen, however, may also cause unpleasant effects. Procedures to remove the wax may cause bleeding and infection. The ear canal may be scraped and scratched or the eardrum may be injured, which may cause deafness.

For more information about DMC Sinai-Grace Hospital’s audiology and hearing services or to make an appointment, call 313-966-4725.