It protects the skin of the ear canal, assist in cleaning, lubrication and antibacterial effects
Excess cerumen can press against the eardrum or occlude (block) the external
auditory canal or hearing aids,
Cerumen is a viscous secretion which contains shed layers of skin, keratin, fatty acids and cholesterol Two forms – dry type and wet type Wet type is dominant and dry type is recessive Asians and native Americans – gray and flaky African and European – brown and dark brown
In older persons – earwax becomes dense and drier Hair becomes thicker and coarse – entrapping the hard dry cerumen in the canal Water that enter the canal during a shower or swimming may cause swelling of the cerumen resulting in blockage of the canal.
Partial hearing loss Hearing aids malfunction due to increased ear wax impaction Otalgia Feeling of fullness in the ear
Cleaning of the ear canal occurs as a result of epithelial migration aided by jaw movement Along with the wax, debris and other unwanted particles is been carried towards outward of the ears
Symptoms
External ear
Middle ear
Itch
Yes
Pain
Yes
Yes
Discharge
Yes
Yes
Deafness
Yes
Yes
Inner ear
Yes
Dizziness
Yes
Tinnitus
yes
1. Course of symptoms: history of gradual hearing loss. 2. Associated symptoms: dizziness and tinitus 3. History of trauma 4. Use of medicine
Ear wax removal is discouraged unless excess earwax is causing health problems Ear Syringing or irrigation Wax softners – cerumenolytics Suction Instrumentation -Curette method Cotton swabs – push most of the earwax into the ear canal and remove only a small portion of the wax and also adhere the fibers.
Cerumenolysis Topical preparations to remove ear wax Cerumenolytics are oil,and glycerine, Sodium bicarbonate in water, olive oil Cerumol (turpentine and dichlorobenzene) Docusate, emulsifuying agent Should be used 2-3 times (1-2 drops) daily for 3 – 5 days prior to the cerumen extraction.
Otitis externa refers generalized inflammation through outer ear canal is often associated with infection.
Symptom presentation: itching, irritation and pain Discharge: usually present Systemic symptoms: otitis externa should not present with any systemic symptoms
Topical treatment in uncomplicated OE Suction Analgesics Keeping ear dry Ear swabs - only in resistant/ chronic OE
Primary treatment of otitis externa (OE) involves management of pain, removal of debris from the external auditory canal (EAC), administration of topical medications to control edema and infection, and avoidance of contributing factors. Most cases can be treated with over-the-counter analgesics and topical eardrops. Commonly used eardrops include acetic acid drops, which change the pH of the ear canal; antibacterial drops, which control bacterial growth; and antifungal preparations. Eczematoid (psoriatic) OE often responds to topical steroid drops but may be chronic or recurrent.
In severe cases, oral or intravenous (IV) antibiotic therapy and narcotic analgesics may be required. In the case of necrotizing (malignant) OE, the patient must be admitted to a hospital for IV antibiotic therapy at the discretion of the consulting otorhinolaryngologist.
Warm the drops by holding the bottle in your hands for a few minutes. Ear drops may make you dizzy or cause nausea if they are too cold. Gently shake the bottle. Lie down or tilt your head to one side. Do not touch the tip of the bottle to your ear. Germs from your ear can spread to the medicine bottle if your ear touches the tip. Gently pull and hold your ear up and back.
Gently squeeze the bottle to drop the correct number of drops into your ear. Your healthcare provider may tell you to use a cotton ball to keep the medicine in place. Place the cotton ball gently just inside your ear. Do not push it into the canal. Use a clean cotton ball each time you use the ear drops. Repeat these steps for the other ear, if needed. Replace the cap on the bottle
