Cerumen Impaction Removal
Justin O. Sevy, Anumeha Singh
Abstract
Production of cerumen (earwax) is a normal process in humans and many other mammals. Cerumen moisturizes the skin of the external auditory canal and protects it from infection, providing a barrier for insects and water. Cerumen is typically expelled from the ear canal spontaneously through natural jaw movement. However, in certain individuals, the self-cleaning mechanism fails, and cerumen can become impacted. Cerumen impaction can occlude the canal or press against the tympanic membrane, potentially causing ear discomfort, conductive hearing loss, itching. Cerumen impaction occurs in up to 6% of the general population, affecting 10% of children and greater than 30% of the elderly and cognitively impaired. It is often seen in patients who routinely wear hearing aids or earplugs or patients with exostoses or anatomic abnormalities of the external ear canal.Excessive buildup of cerumen is likely underdiagnosed and undertreated. In the United States, it leads to 12 million patient visits and eight million cerumen removal procedures each year. It can interfere with tympanic membrane examination as well as audiometry and hearing aid fitting. It is diagnosed by direct visualization by a trained provider using an otoscope.