This document discusses impacted ear wax. It defines impacted wax as an excess collection of thick ear wax. Symptoms of impacted wax include diminished hearing of sudden onset, discomfort without pain usually, and occasionally tinnitus. Treatment options include using ear drops containing ceruminolytics for 4-5 days before syringing or using a wax hook to remove it. Self-care options are using ear drops to soften wax or olive oil warmed on a spoon. Ear irrigation can help hearing for those with impacted wax if done at low pressure, but should be avoided if the eardrum is perforated or in cases of mastoid surgery, chronic ear disease, unilateral deafness, or recurrent ear infections/tinnitus

1. Impacted Wax

2. Introduction
• Ear Wax (Cerumen) is a natural protective
oily substance which is produced in the
outer third of the ear canal.
• Its function is to remove small foreign
particles, such as dust, from the canal.
• This is achieved by the ciliary hairs.

3. Definition
• Excess collection of thick ear wax is known
as impacted wax.

4. Impacted Wax

6. Symptoms
• Diminished hearing
– often of sudden onset after “cleaning” the
ears
• Discomfort
– seldom complain of pain unless the wax is
pressing on the drum
• Tinnitus occasionally

7. Educational
Points
Wax is a normal physiological substance which
has an important role in protecting the ear canal
The ear canal is a self-cleaning system, do not to
use cotton buds as wax is more likely to be
pushed back against the eardrum and become
impacted.
Ear wax only needs to be removed if it causes
symptoms or if a proper view of the eardrum is
needed.

8. Primary Care Treatment
• In more severe cases use of a
ceruminolytic ear drop for 4 to 5 days
prior to syringing is advisable
• Removal with wax hook is also an option

9. Formby cerumen hook and
scoop

11. Self Care
Ear drops to soften ear wax (ceruminolytics) may be
used as the only treatment in mild cases.
There are many different preparations on the market,
none with any clear clinical advantage compared to the
others.
Sodium bicarbonate may be effective at disintegrating
ear wax.
A simple home remedy is olive oil, warmed by pouring
onto a warm spoon.
Preparations containing organic solvents are particularly
likely to cause irritation and inflammation of the external
ear canal and should be avoided.

12. Ear Irrigation
• Ear irrigation to improve hearing in those with
•
•
impacted wax
The lowest pressure possible should be used.
It is best avoided if
– the eardrum is known or suspected to be perforated
– there is a history of mastoid surgery or chronic middle
ear disease
– If patient has unilateral deafness
– A history of recurrent otitis externa or tinnitus

13. Ear irrigation syringe

14. Ear irrigation

15. The End