Wax In The Ear

Introduction

Wax (or cerumen) is a normal product of the human external ear. It is a dark brownish mixture of the secretions of the ceruminous and sebaceous glands in the outer third of the external auditory canal.
Small quantities are produced continuously and function to lubricate the canal.
Quantities produced and the consistencies vary.
It may be excessive in some people, causing deafness, ear ache, secondary infection and even vertigo.

Clinical features

  • Sensation of blockage and some degree of deafness are the most common complaints
  • Sometimes, pain and irritation
  • Ear discharge in some cases
  • Quantity seen varies
    • May be soft or hard
    • May be impacted in the deep meatus

Differential diagnoses

Complications

  • Superimposed infection: otitis externa
  • Hearing impairment

Treatment objectives

  • Evacuate the wax and clear the ear

Non-drug treatment

  • Removal with probe and cotton wool: for soft wax
  • Ear syringing: for hard wax, often after preliminary softening with oily drops
  • Occasionally, removal under anaesthesia if syringing is unsuccessful

Drug treatment

  • Ear drops to soften and loosen wax
  • Warm olive oil