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Cerumen Impaction: Diagnosis and Management.

Charlie Michaudet1, John Malaty1

  • 1University of Florida, Gainesville, FL, USA.

American Family Physician
|October 3, 2018
PubMed
Summary

Impacted earwax (cerumen) requires removal if symptomatic or hindering examination. Effective treatments include cerumenolytics and irrigation, while cotton swabs and ear candling should be avoided.

Area of Science:

  • Otolaryngology
  • Primary Care Medicine

Background:

  • Cerumen production is a normal physiological process.
  • Impacted cerumen can cause symptoms like hearing loss, pain, and tinnitus.
  • It can also impede necessary medical examinations.

Purpose of the Study:

  • To outline indications for cerumen removal.
  • To detail safe and effective cerumen removal methods.
  • To advise on contraindications and when to refer patients.

Main Methods:

  • Review of current clinical guidelines and evidence for cerumen management.
  • Identification of effective treatment modalities.
  • Discussion of patient populations requiring special consideration.

Main Results:

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  • Cerumen removal is indicated for symptomatic impaction or when it obstructs examination, especially in non-verbal patients.
  • Effective treatments include cerumenolytic agents, irrigation, and manual removal.
  • Patients with bleeding risks require counseling; cotton swabs and ear candling are contraindicated.

Conclusions:

  • Clinicians should be aware of indications and contraindications for cerumen removal.
  • Appropriate treatment selection is crucial for effective management.
  • Referral to an otolaryngologist is necessary for refractory cases or persistent symptoms.