Symptoms

A typical symptom of the earwax plug is the sudden or insidious onset of the hearing loss, usually unilateral, which often occurs after showering or manipulation in the ear canal. Depending on the nature of the earwax plug, pain may be added. Especially dry and thus hardened cerumen can injure the sensitive mucous membrane of the external auditory canals and lead to cracks, which sometimes bleed.

Small injuries also provide an ideal entry point for bacteria. There is a threat of inflammation of the external auditory canal (otitis externa), which is characterized by an increase in pain and discharge from the affected ear. Earwax has a typical, unpleasant inherent odor.

It is assumed that this is intended as protection against insects or bacteria. The contained antibodies as well as the different fats probably contribute considerably to the inherent odor of earwax. If the smell of earwax changes, however, caution is advised.The cause can be an infection of the auditory canal, for example. A visit to a doctor is recommended.

Diagnosis

For each type of hearing loss, the ear specialist will perform various tests to find out the origin of the disorder. To be able to distinguish between disturbed sound conduction and a disease of the sound processing organs, different tuning fork tests are recommended. In the case of the earwax plug, the underlying cause is impaired sound conduction, which can be eliminated by simple means. To do this, the physician must inspect the ear canal using an optical technique (otoscope) to find the suspected plug. The tuning fork tests and the subsequent examination of the auditory canal are painless procedures.

Therapy

To restore full hearing, it is sufficient to clear the external auditory canal of excess earwax. In mild cases, it is sufficient to rinse the affected ear repeatedly with water at body temperature. If the plug cannot be removed in this way, so-called keratolytic ear drops can be used.

These are drugs that have a horny effect and are used to loosen the upper horny layer of the skin. In ear medicine, they can be used to attack the detached skin scales and other substances trapped in the earwax plug, thus making the cerumen softer and easier to wash out. If all attempts to clean the ear canal by dissolving and washing out the earwax fail, the doctor must try to remove the plug mechanically.

This is done under optical control, which is ensured by the otoscope. A small probe, usually in the form of a spoon or with a small metal loop, is inserted through an ear funnel attached to the external auditory canal, and the plug is carefully mobilized and scraped out. Since the mucosa of the external auditory canal is very sensitively innervated and well supplied with blood, pain and slight bleeding may occur.

However, most patients tolerate the procedure very well and can be performed without anaesthetic. If the earwax is very soft or the mechanical removal is incomplete, the external auditory canal can be suctioned off with a special suction cup. Earwax cleans and protects the auditory canals.

The produced earwax is continuously transported out of the ear canal. One reason for this is the movement of the nearby jaw joint when speaking or chewing. For various reasons, however, earwax can accumulate and block the auditory canal.

If this is the case, manual cleaning of the auditory canal may be necessary. In the meantime, cleaning with cotton swabs is generally not recommended as the risk of injury is too high. In addition, the earwax is often pressed into the ear, which can cause a massive plug.

Therefore a careful cleaning of the auricle with a moist cloth is usually recommended. However, this should not be pressed into the ear canal either. The back of the auricle should not be forgotten.

A careful rinsing of the ear canal helps against stubborn earwax inside the ear canal. The water should be at body temperature. If it is too warm or too cold, dizziness may occur.

If you carefully pour the water into the ear canal, for example with a syringe, the earwax usually liquefies. Now it can emerge from the ear and be wiped off. Then the ear should be dried thoroughly.

Ear drops sold over the counter work in a similar way. In some cases, however, this is not enough. In this case a visit to a doctor is recommended.

The doctor has several methods to choose from to remove the earwax. These include rinsing, suction or the use of a fine chopping. In addition, he often first inspects the ear to rule out diseases of the ear as the cause of the blockage.

Earwax suction is performed with special equipment. Some of the devices that can be purchased differ greatly from the professional devices used by ENT specialists, for example. Their cleansing effect is often no greater than that of a correctly performed ear wash. Earwax fulfils many important tasks.

These include cleaning the ear canal and protecting it from infections or insects. For this reason, regular suctioning of the ears only makes sense in exceptional cases. A doctor can easily determine whether regular suctioning is necessary.In most cases, regular visits to the doctor for ear cleaning are sufficient in such cases.

Numerous ear sprays are available in the trade, which promise a gentle cleaning of the external auditory canal without cotton swabs, either on oil or sea salt basis as well as by the addition of certain (keratolytic-horn dissolving) active substances, which are to dissolve the earwax. The sprays are usually supplied in a pressure vessel and sprayed into the ear via an applicator. Dissolved components of the earwax can be removed after a short exposure time at the auricle with a damp washcloth.

It should be noted that, as already mentioned, the ear canal does not require regular cleaning. If used too frequently, ear sprays can also cause the protective layer of earwax to disappear and infections to spread. If there are already restrictions of hearing or even pain caused by a plug of earwax, ear sprays do not replace consultation with a doctor and professional cleaning of the auditory canal.