Ear wax, or cerumen, is a hydrophobic protective covering in the ear canal. It acts to protect the skin of the external canal from water damage, infection, and trauma, and traps foreign particles and aids in elimination of bacteria.
Overproduction — Some individuals produce a volume of cerumen that overcomes the ear canal's ability to eliminate it in the absence of ear canal disease. This can occur as a response to local trauma, because of retained water in the ear canal, or can be idiopathic.
Removal methods
The most commonly used cerumenolytics are preparations of mineral oil and hydrogen peroxide that are commercially available over-the– counter. Patients with drying of the skin of the ear canal or excessive exfoliation of the ear canal skin should avoid preparations containing hydrogen peroxide; plain mineral oil and liquid docusate sodium are effective for these individuals. Several trials have compared cerumenolytics and found no consistent evidence that any one cerumenolytic is superior to another
Similar to curettes and cerumen spoons, there are no data investigating the efficacy of lavage for cerumen removal. I typically use lavage of the ear canal with a syringe and warm water treated with a bacteriostatic agent (such as dilute hydrogen peroxide 1:10) to remove soft cerumen that is distal in the ear canal and incompletely obstructing cerumen. It tends not to be effective for hard impaction.
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