Cerumen impaction

Cerumen (ear wax) is a naturally occurring substance that cleans, protects, and lubricates the external auditory canal.

Impaction is diagnosed when an accumulation of cerumen results in symptoms, such as hearing loss, or when it prevents adequate assessment of the ear canal or tympanic membrane.

Intervention may include manual removal, irrigation, or use of cerumenolytic agents, or a combination of these modalities.

After treatment, the clinician should re-examine the patient's ear and document the resolution of the cerumen impaction, and also inspect the previously occluded tympanic membrane.

Young children, older patients, hearing aid users, individuals with a cognitive impairment, and those in nursing homes are at higher risk for cerumen impactions.

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]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. https://journals.sagepub.com/doi/abs/10.1177/0194599816671491 http://www.ncbi.nlm.nih.gov/pubmed/28045591?tool=bestpractice.com [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].