Cerumen Impaction

GENERAL INFORMATION:

What is cerumen impaction? Cerumen (se-ROO-men) impaction (im-PAK-shun) is the blockage of the outer ear canal by tightly packed cerumen. The outer ear canal is the tube from the opening of your ear to the eardrum. Cerumen, also called ear wax, is the yellowish oily substance produced in the outer ear canal. 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 germs, such as 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.

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

• Advanced age wherein 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 buds (swabs), or using needles, hair pins, or other objects to clean the ears.

What are the signs and symptoms of cerumen impaction? 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.

How is cerumen impaction diagnosed? Your caregiver will take a detailed history from you. This includes any ear problems or procedures you may have had. Your caregiver 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 caregiver may look for other problems, such as bleeding, infection, or injury. Your eardrums will be checked for tears or holes. Your caregiver may also test your hearing.

How is cerumen impaction treated? 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 caregiver which of the following treatments may be best for you:

• Wax softeners: Ear drops 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 take out the ear wax.
  
  
• Procedures: When the impaction can be clearly seen, removal may be done using any of the following:
  
  
  • Irrigation: This procedure may also be called ear syringing. Water that is close to 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.

What are the risks of having a cerumen impaction? 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. Ask your caregiver if you have questions about your condition and its treatment.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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