Definition

Cerumen is the soft yellow wax made by glands in your ear canal. It is more commonly known as earwax. Cerumen impaction is a build-up of earwax that becomes wedged in, blocking the ear canal.

Causes

Cerumen impaction is usually caused by:

• An inability of the ear to naturally clear itself of cerumen due to hardening
• Putting objects into your ears that push the cerumen deeper into the ear canal

Risk Factors

Cerumen impaction is more common in older adults. It can cause hearing loss.

Other factors that may increase your chance of cerumen impaction include:

• Trying to remove cerumen with a cotton-tipped swab
• A twisted, narrow, or complicated ear canal
• Ears that overproduce or make thick cerumen
• Dense hair growth in the ear canal
• Hearing aid use
• Intellectual disability

Symptoms

Symptoms may include:

• Itchy ear
• Pain in the ear
• Ringing in the ear—tinnitus
• Hearing loss

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. An ear exam will be done to look for impacted cerumen.

Treatment

Treatment involves removal of the earwax from the ear canal. Talk with your doctor about the best treatment plan for you. Cerumen can be removed by:

• Using one of several instruments, including:
  • Curette—This is a surgical instrument shaped like a scoop.
  • Suction—When the cerumen is loosened, the earwax will be vacuumed.
• Flushing—The impacted cerumen may be rinsed using flushing equipment.
• Ceruminolytic agents—A ceruminolytic agent may be prescribed. This is a liquid-like solution used in the ear to soften the earwax and ease removal.

Earwax moves out of your ear naturally. Earwax should not be removed by you. In fact, continuously trying to clean your ear of cerumen by using a cotton swab, for example, can damage your ear. By trying to remove earwax, you can:

• Damage your eardrum—the membrane that vibrates and transmits sound to the middle ear
• Make yourself more prone to otitis externa—an infection or inflammation of the skin that lines the ear canal
• Injure the ear canal
• Cause the cerumen to become more impacted and more difficult to remove

Prevention

To help reduce your chance of cerumen impaction:

• Do not clean your ears with anything more than a soapy washcloth on the outer rim of your ear.
• Do not use cotton-tipped swabs to clean anywhere inside your ears.
• Use medications as advised by your doctor to help prevent the build up of earwax.
• If you are concerned about earwax, see your doctor. Do not attempt to remove the earwax by yourself.
• Schedule regular visits to remove earwax build up as advised by your doctor.

American Speech–Language–Hearing Association http://asha.org

Health Canada http://www.hc-sc.gc.ca

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Olusanya BO. Hearing impairment in children with impacted cerumen. Ann Trop Paediatr. 2003;23(2):121-128.

Pray WS, Pray JJ. Earwax: Should it be removed? US Pharmacist. 2005;30(5).

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