Cerumen removal
Overview
- Cerumen impaction is caused by the buildup of wax within the ear canal and can lead to decreased hearing, pressure or fullness, dizziness, tinnitus, or pain.
Indications
- Pain, hearing loss, vertigo, disequilibrium
- Visualization of symptomatic TM
Contraindications
- TM rupture or myringotomy tubes
Equipment Needed
- Warm Water
- 5 or 10 cc syringe
- Soft tubing from catheter
Procedure
Three Methods
- Cerumenolytic agents
- Water based
- acetic acid, colace, hydrogen peroxide, sodium bicarbonate, sterile saline
- Oil Based
- Almond oil, Peanut oil, Olive oil, Mineral oil
- Debrox
- Water based
- Irrigation
- 5 cc syringe with warm water and soft tubing from catheter
- Jet lavage
- Repeat until wax flushed out
- Manual Removal
- Perform under direct visualization
- Soft, disposable plastic variety preferred to metal cerumen spoon/curettes
Complications
- Increased risk of infection in immune compromised patients
- Hemorrhage or hematoma in patients on anticoagulation
- Irrigating with cold or hot solution may lead to vertigo, nausea, vomiting
See Also
External Links
References
- Buttaravoli and Hulsey, Cerumen Impaction, Chapter 26, Minor Emergencies, 3rd edition, 2013
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