Cerumen impaction
Summary
Definition
Cerumen is a mixture of secretions and sloughed epithelial cells. A cerumen impaction is an accumulation of cerumen that causes symptoms, such as hearing loss, fullness, otorrhea, tinnitus, dizziness, or other symptoms, and/or prevents a required assessment of the ear canal, tympanic membrane, or audiovestibular system.[1][Figure caption and citation for the preceding image starts]: Cerumen accumulationReprinted with permission from: Hawke M. Ear disease: a clinical guide. Hamilton, London: Decker DTC, 2003 [Citation ends].
History and exam
Key diagnostic factors
- visualization of cerumen
- hearing loss
- fullness in the ear
Other diagnostic factors
- otorrhea
- otalgia
- tinnitus
- cough
- vertigo
Risk factors
- age >50 or <5 years
- male sex
- stenotic ear canal
- Down syndrome
- cotton-tipped applicator use
- hearing aid use
- living in a nursing home
Diagnostic tests
Tests to consider
- audiogram
Treatment algorithm
all patients
Contributors
Authors
Stephen Wetmore, MD, MBA, FACS
Professor Emeritus
Department of Otolaryngology
West Virginia University School of Medicine
Morgantown
WV
Disclosures
SW declares that he has no competing interests.
Peer reviewers
Rahul K. Shah, MD, FAAP
Associate Professor of Otolaryngology and Pediatrics
Division of Otolaryngology
Children's National Medical Center
Assistant Professor
Otolaryngology and Pediatrics
George Washington University School of Medicine and Health Sciences
Washington
DC
Disclosures
RKS declares that he has no competing interests.
Seth R. Schwartz, MD, MPH
Director of Research
The Listen For Life Center At Virginia Mason
Otology/Otolaryngology
Department of Otolaryngology
Virginia Mason Medical Center
Seattle
WA
Disclosures
SRS is an author of a reference cited in this topic.
Robin Youngs, MD, FRCS
Consultant Otologist
Gloucestershire Royal Hospital
Gloucester
UK
Divulgaciones
RY declares that he has no competing interests.
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical practice guideline (update): earwax (cerumen impaction). Otolaryngol Head Neck Surg. 2017 Jan;156(1_suppl):S1-29.Texto completo Resumen
Roeser RJ, Ballachanda BB. Physiology, pathophysiology, and anthropology/epidemiology of human ear canal secretions. J Am Acad Audiol. 1997 Dec;8(6):391-400. Resumen
Horton GA, Simpson MTW, Beyea MM, et al. Cerumen management: an updated clinical review and evidence-based approach for primary care physicians. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720904181.Texto completo Resumen
Roland PS, Eaton DA, Gross RD, et al. Randomized, placebo-controlled evaluation of Cerumenex and murine earwax removal products. Arch Otolaryngol Head Neck Surg. 2004 Oct;130(10):1175-7.Texto completo Resumen
Aaron K, Cooper TE, Warner L, et al. Ear drops for the removal of ear wax. Cochrane Database Syst Rev. 2018 Jul 25;(7):CD012171.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- External otitis
- Keratosis obturans
- Polyp of ear canal
Más DiferencialesGuías de práctica clínica
- Clinical practice guideline (update): earwax (cerumen impaction)
Más Guías de práctica clínicaFolletos para el paciente
Ear wax
Más Folletos para el paciente
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