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“Patients may try to blindly instrument their ears with cotton ear
buds, bobby pins, or other tools,” said Dr. Seth Schwartz, chair of
a committee that drafted new guidelines for diagnosing and treating
earwax for the American Academy of Otolaryngology – Head and Neck
Surgery.
“These are generally ineffective and potentially dangerous,”
Schwartz, director of the Listen For Life Center at Virginia Mason
in Seattle, said by email.
“Scratching of the ear canal skin can lead to pain and infection,”
Schwartz added. “Sometimes they just push the wax in further, and
there also is the potential for damage to the ear drum.”
The body makes earwax, or cerumen, to keep ears clean and trap
substances like dust and dirt, preventing debris from getting
further into the ear where it can cause damage. As new skin grows in
the ear canal, it pushes old earwax from the inside of the ears
closer to the opening where it naturally flakes off or washes away
during bathing.
Often, there’s nothing wrong with having a little earwax near the
opening, doctors stress in guidelines published in
Otolaryngology–Head and Neck Surgery.
But when the ear’s self-cleaning process doesn’t work well, too much
earwax may accumulate and partially or fully block the ear canal.
This can cause problems including pain, itching, discharge from the
ear, ringing in the ear or hearing loss.
Roughly one in 10 children and one in 20 adults suffer from
excessive earwax buildup, as do more than one third of elderly
people, according to the guidelines.
Excessive cleaning can irritate the ear canal, cause infection, and
even increase the chances of excessive buildup, or what’s known as
cerumen impaction, the guidelines note.
There’s no evidence that using ear candles, a process that relies on
heat to remove buildup, actually works at clearing impaction, and
this can cause serious damage to the ear canal and eardrum, the
guidelines also emphasize.
Patients should see a doctor if they experience hearing loss, pain
or feel fullness in their ears or aren’t certain whether the amount
of wax is normal.
People should also get a checkup if they have ear drainage or
bleeding because these symptoms aren’t tied to impaction and may be
an indication of other problems.
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“The mantra from previous generations of 'don't stick anything in
your ear that is smaller than your elbow’ still applies,” said Dr.
Duane Taylor, chief executive officer and medical director of Le
Visage ENT and Facial Plastic Surgery in Bethesda, Maryland.
“Generally people still erroneously believe that the cotton-tipped
applicator or Q-tip is the primary weapon of choice to get rid of
earwax,” Taylor, who wasn’t involved in the guidelines, said by
email.
In most cases, though, wax that’s naturally found near the outer
part of the ear can be wiped away with a damp cloth, Taylor added.
Cotton-tipped applicators can compact the wax and push it deeper
into the ear, making it harder to remove.
Certain hearing aids, or wearing earbuds instead of over-the-ear
headphones, can also inadvertently push wax deeper into the ear,
Taylor said.
At home, people may be able to use wax removal drops, baby oil or a
few drops of hydrogen peroxide to prevent buildup, but it’s best to
consult a doctor first.
“In most cases, primary care clinicians are the first line of
evaluation for this condition and are adequately equipped to manage
it,” Taylor said. “When it is noted to be more complicated or there
is a risk of injury there should be a referral to an Ear, Nose and
Throat physician for removal.”
SOURCE: http://bit.ly/2ivm9XW Otolaryngology–Head and Neck Surgery,
online January 3, 2017.
(Corrects name of journal in source line at end of story.)
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