Impacted earwax

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Impacted earwax, also known as cerumen impaction, is a condition where earwax accumulates in the ear canal to an extent that it causes symptoms or blocks the passage of sound into the ear. Earwax, or cerumen, is a natural substance produced by glands in the outer part of the ear canal. It plays a crucial role in the ear’s self-cleaning process, protecting the ear by trapping dust, microorganisms, and other foreign particles. However, problems arise when there is an excessive buildup, leading to impaction. This article delves into the causes, symptoms, diagnosis, treatment, and prevention of impacted earwax, shedding light on this common yet often misunderstood condition.

 

Understanding Earwax and Its Functions

Earwax is composed of keratin (from shed skin cells), fatty acids, alcohols, squalene, and cholesterol. The composition and consistency of earwax can vary based on ethnicity, diet, age, and other factors. There are two primary types of earwax: wet and dry. The type of earwax an individual has is determined genetically.

 

The primary functions of earwax include lubricating the ear canal, providing protection against bacteria, fungi, insects, and water, and aiding in the cleaning and removal of dead skin cells from the ear canal.

 

Causes of Impacted Earwax

Impacted earwax can result from several factors, including:

 

  • Excessive Production: Some individuals naturally produce more earwax, increasing the risk of impaction.
  • Narrow or Irregular Ear Canals: Anatomical variations can hinder the natural exit of earwax.
  • Frequent Use of Earplugs or Hearing Aids: These devices can push earwax deeper into the ear canal.
  • Age: The consistency of earwax changes with age, becoming harder and more likely to form a blockage.
  • Improper Ear Cleaning: Using cotton swabs or other objects to clean the ear can push wax deeper into the canal, leading to impaction.

 

Symptoms of Impacted Earwax

The accumulation of earwax can lead to various symptoms, including:

 

  • Hearing Loss: Partial or full hearing loss in the affected ear is common.
  • Earache: Pain or discomfort in the ear may occur.
  • Tinnitus: Some people may experience ringing or buzzing sounds in the ear.
  • Fullness or Pressure: A sensation of fullness or pressure in the ear is often reported.
  • Dizziness: In some cases, impacted earwax can lead to vertigo or dizziness.
  • Cough: The stimulation of the vagus nerve by impacted wax can sometimes trigger a cough.

 

Diagnosis

The diagnosis of impacted earwax is typically straightforward. A healthcare provider will review the patient’s symptoms and medical history and conduct a physical examination of the ear using an otoscope, a device that allows for a clear view of the ear canal and eardrum.

In some cases, if the object is not visible or if there is concern about damage to the ear structures, additional tests such as a tympanometry (to assess the functioning of the middle ear) or an audiogram (to test hearing) might be conducted.

Treatment Options

Treatment for impacted earwax aims to remove the buildup safely and effectively, with options including:

 

  • Microsuction: A minimally invasive procedure where a small suction device is used to gently remove the earwax.
  • Ear Irrigation: A gentle washout of the ear canal with warm water or a saline solution to soften and remove the wax.
  • Ear Drops: Commercially available or prescription ear drops can soften the earwax, facilitating its natural expulsion.
  • Manual Removal: Using specialised instruments, a healthcare professional can carefully remove the earwax under direct vision.

 

It’s crucial to avoid attempting to remove impacted ear wax with cotton swabs, hairpins, or other objects, as these can push the wax further into the ear canal or cause injury.

 

Prevention

Preventing impacted earwax involves adopting safe ear-cleaning practices and avoiding the overuse of earplugs and hearing aids when possible. Individuals prone to earwax buildup might consider regular check-ups with a healthcare provider to manage the condition proactively.

 

Conclusion

Impacted earwax is a prevalent issue that can lead to discomfort and hearing disturbances. Understanding its causes, symptoms, and treatment options is essential for effective management. By adhering to proper ear care practices and seeking professional assistance when necessary, individuals can prevent the complications associated with impacted earwax and maintain optimal ear health.

When should you see an ENT specialist in Singapore?

Please consult an ENT specialist if you are suffering from any ear, nose, or throat symptoms. It is also advisable to visit an ENT doctor if you experience persistent mouth breathing due to a chronic blocked nose or encounter snoring issues.

Dr Ker Liang sees adults and children for general ENT conditions and provides comprehensive management in a broad range of Ear, Nose, and Throat, as well as Head and Neck conditions. She has a special interest in treating throat and voice conditions, including persistent sore throat, voice issues, snoring, and Obstructive Sleep Apnoea (OSA).

Medical Teaching

Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.

Medical Teaching

Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.

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Dr Ker Liang
ENT Surgeon

MBBS (S’pore), MRCS (Edin),
MMed (ORL), ACGME-I (ORL)

Specialising in the diagnosis and treatment of a wide range of conditions affecting the

ENT system, our doctor brings expertise, compassion, and a personalised approach to

every patient interaction. From common concerns such as allergies and sinus issues to

more complex conditions like hearing loss and throat disorders, our ENT specialist is

equipped to address your unique health needs with skill. 

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