Cerumen impaction
小结
定义
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, otorrhoea, 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].
病史和体格检查
关键诊断因素
- presence of risk factors
- visualisation of cerumen
- hearing loss
- fullness in the ear
其他诊断因素
- otorrhoea
- otalgia
- tinnitus
- cough
- vertigo
危险因素
- age >50 or <5 years
- male sex
- stenotic ear canal
- Down's syndrome
- cotton-tipped applicator use
- hearing aid use
- living in a nursing home
诊断性检查
需考虑的检查
- audiogram
治疗流程
all patients
撰稿人
作者
Stephen Wetmore, MD, MBA, FACS
Professor Emeritus
Department of Otolaryngology
West Virginia University School of Medicine
Morgantown
WV
利益声明
SW declares that he has no competing interests.
同行评议者
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
利益声明
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
利益声明
SRS is an author of a reference cited in this topic.
Robin Youngs, MD, FRCS
Consultant Otologist
Gloucestershire Royal Hospital
Gloucester
UK
利益声明
RY declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
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.全文 摘要
Roeser RJ, Ballachanda BB. Physiology, pathophysiology, and anthropology/epidemiology of human ear canal secretions. J Am Acad Audiol. 1997;8:391-400. 摘要
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.全文 摘要
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.全文 摘要
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.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- External otitis
- Keratosis obturans
- Polyp of ear canal
更多 鉴别诊断指南
- Clinical practice guideline (update): earwax (cerumen impaction)
更多 指南患者教育信息
Ear wax
更多 患者教育信息
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