Symptoms
An earwax plug can cause uncomfortable hearing, a feeling of pressure, fullness, ear pain, itching, ringing in the ears, and dizziness. However, symptoms do not necessarily occur. Because it obstructs the view, the earwax plug makes medical diagnosis more difficult, for example, in the case of a suspected middle ear infection.
Causes
Earwax (cerumen) consists partly of secretions produced by the earwax glands and partly of detached epithelial cells. It is antibacterial, has caring properties and an important cleaning and protective function for the external auditory canal. Supported by the jaw movements, it is continuously transported to the outside. Its components include a high proportion of keratin, fatty acids, alcohols, squalene and cholesterol. An earwax plug is formed in the external auditory canal by the accumulation and thickening of earwax that cannot be properly removed. The result is partial or complete obstruction of the ear canal. Risk factors include:
- Predisposition, for example, a particular anatomy of the ear canal.
- Cleaning with cotton swabs
- Age: children, elderly
- Disabilities, cognitive impairment
- Use of hearing aids and hearing protection plugs.
- Individual components of the earwax
Diagnosis
Diagnosis is made in medical treatment based on symptoms, patient history and with a physical examination. This involves inspecting the external auditory canal with an otoscope or other suitable instrument. Similar symptoms are also caused, for example, by inflammation of the external auditory canal, a cold, tubal catarrh, foreign bodies, a hearing loss, or otitis media.
Treatment
Observational waiting (“watchful waiting”) may be recommended before intervention. In some cases, the problem may resolve on its own. Medical therapy:
- Under medical treatment, the clot can be removed by various methods such as suction, irrigation, or manually with a special instrument such as a curette, spoon, or forceps. Surgical intervention is rarely required.
- Because the external auditory canal is innervated by the vagus nerve, stimulation by earwax or an attempt to clean it can cause coughing and, rarely, cardiac depression and loss of consciousness. Other possible complications of removal include tympanic membrane perforation, injury, pain, infection, and inflammation of the ear canal.
Cerumenolytics:
- The so-called cerumenolytics are liquid preparations for local application, which soften or dissolve the plug. This is usually followed by an ear irrigation. Many different substances are used. These include, for example, hydrogen peroxide 3%, highly dilute acetic acid, olive oil, almond oil, saline solution, sodium bicarbonate solution, docusate sodium, and water. Cerumenolytics should not be used for tympanic membrane perforation. The acids and oxidizing agents are of limited use for children because they may cause a burning sensation. In persistent cases, application for several days may be indicated.
Ear rinses:
- Ear irrigation can also be performed by patients themselves, for example, with an ear syringe (pear syringe) or an ear shower and lukewarm water. Not too much pressure should be applied.
Alternative medicine:
- Ear candles are not recommended in the scientific literature for the removal of an earwax plug. However, they are popular among clientele.
Prevention
For the removal of earwax should not use cotton swabs or other instruments, because they promote the formation of a plug of earwax. They push the earwax in the direction of the eardrum. Instead, the outer ear can be cleaned with a washcloth or warm water, for example. For prevention, nourishing ear drops and cleansing ear sprays can be recommended for risk factors.
