Cerumen impaction;

Alternative names
Ear impaction; Wax blockage; Ear blockage; Ear wax

Definition
Wax blockage is obstruction of the ear canal with cerumen (wax).

Causes, incidence, and risk factors

The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen. This protects the ear by trapping dust, microorganisms, and other foreign particles and preventing them from entering and damaging the ear. The wax usually makes its way to the opening of the ear where it falls out or is removed by washing.

In some people, the glands produce more wax than can be easily excreted from the ear. This extra wax may harden within the ear canal and block the ear. More commonly, the ear canal may be blocked by wax when attempts to clean the ear push wax deeper into the ear canal and cause a blockage.

Wax blockage is one of the most common causes of hearing loss.

Symptoms

     
  • Partial hearing loss, may be progressive  
  • Noises in the ear (tinnitus)  
  • Earache  
  • Fullness in the ear or a sensation that the ear is plugged

Signs and tests

During a physical examination, the health care provider will look into the ear for signs of wax blockage.

Treatment

Most cases of ear wax blockage can be treated at home. Mineral oil, baby oil, glycerin, or commercial drops can be used to soften wax in the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide may aid in the removal of wax.

Another method to remove wax is irrigation of the ear. Body-temperature water should be used (cooler or warmer water may cause a response consisting of brief but severe dizziness or vertigo). With the head upright, straighten the ear canal by holding the external ear and gently pulling upward. Use a syringe to gently direct a small stream of water against the ear canal wall next to the wax plug. Tip the head to allow the water to drain. Irrigation may need to be repeated several times.

Never irrigate the ear if the eardrum is not known to be intact, because irrigation with a ruptured eardrum may cause ear infection or acoustic trauma. Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik) because the force of the irrigation may damage the eardrum.

After the wax is removed, the ear should be dried thoroughly. A few drops of alcohol in the ear or a hair dryer set on low may be used to help dry the ear.

If attempts to remove the wax plug are unsuccessful, consult a health care provider, who may remove the wax by repeating the irrigation attempts, suctioning the ear canal, or removing wax with a small device (curette). Occasionally, the wax must be removed with the help of a microscope.

Expectations (prognosis)

Wax blockage of the ear usually responds well to removal attempts, but may happen again in the future. Hearing loss is usually temporary and usually returns completely after removal of the blockage.

Complications

     
  • Perforated eardrum  
  • Middle ear infection (otitis media)  
  • External ear infection (otitis externa)  
  • Permanent hearing loss from acoustic trauma

Calling your health care provider

Call for an appointment with your health care provider if the ears are blocked with wax and attempts to remove the wax are unsuccessful.

Also call if earwax blockage has been present and new symptoms develop, especially drainage from the ear, persistent or severe ear pain, fever, or persistent hearing loss.

Prevention

Individuals who suffer from frequent blockages may benefit from weekly irrigations. Never attempt to clean the ear by placing any object into the ear canal (such as a Q-tip). It is better to clean the outer ear canal by using a cloth or tissue paper wrapped around your finger.

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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