Wax impaction

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Overview

Earwax, referred to as cerumen auris, is a protective normal secretion from the external auditory canal outer third cartilaginous skin gland. It is a mixture of mainly 60% desquamated, 12–20% saturated and unsaturated long-chain fatty acid and 6–9% cholesterol. It lubricates the external auditory canal. It also traps dust with other small particles and insects, thereby preventing them from reaching and damaging the eardrum. It also provides protection from infecting agents such as bacteria and fungi.[6] The antimicrobial activity is due to fatty acid, lysosome, and acidity of the wax. It gets dries up and fall out of the external auditory canal with a trapped particle by conveyor belt process of epithelial migration assisted by jaw movement during chewing and talking. Earwax impaction is one of the most common ear pathology treated in the otolaryngological clinic worldwide, in the USA, about 6% of the population suffer from impacted cerumen. Earwax is said to be impacted when its accumulation in the external auditory canal is symptomatic or prevent assessment of the canal and eardrum or both. Impacted earwax causes discomfort such as irritation, blockage, hard of hearing, earache, noise in the ear or head, and dizziness. The habit of toileting the ear using objects which pushes in wax such as cotton tipped swab, pin, and hearing aid predisposed to earwax impaction. Ear picking and or its resultant ear infection, abnormalities of external auditory canal, foreign body impaction, excessive earwax production due to anxiety, fear and stress, and aging are among important factors leading to earwax impactions. These preventable conditions are predominantly due to human activities that can result in complications such as ear injuries and foreign body impaction in the ear. The knowledge of the predisposing factors could tremendously reduce the prevalence of earwax impaction and its associated complications. There is dearth of literature on the earwax impaction from Nigeria. This study aimed at determining the clinical presentation, predisposing factors, and perception of earwax impaction among Nigerians.

Symptoms

Earache.

Feeling of fullness in the ear.

Ringing or noises in the ear (tinnitus)

Hearing loss.

Dizziness.

Cough.

Itchiness in the ear.

Odor or discharge in the ear.

Causes

The wax in your ears is made by glands in the skin of your outer ear canal. The wax and tiny hairs in these passages trap dust and other materials that could damage deeper parts of your ear, such as your eardrum.

In most people, a small amount of earwax regularly makes its way to the ear opening. At the opening, it's washed away or falls out as new wax replaces it. If your ears make too much wax or if earwax isn't cleared well enough, it may build up and block your ear canal.

Earwax blockages often happen when people try to get earwax out on their own by using cotton swabs or other items in their ears. This usually just pushes wax deeper into the ear, rather than removing it.

Bony blockage (osteoma or exostoses)

Infectious disease, such as swimmer's ear (external otitis)

Skin disease (such as eczema)

Autoimmune disease (such as lupus)

Narrowed ear canal (from birth, chronic inflammation, or injury)

Making too much earwax due to injury.

Risk factors

Ear picking and or its resultant ear infection, abnormalities of external auditory canal, foreign body impaction, excessive earwax production due to anxiety, fear and stress, and aging are among important factors leading to earwax impactions.

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Complications

Swimmer's ear (otitis external)

Earache.

Short-term (temporary) hearing loss.

Dizziness.

Retention of water in the canal.

Eardrum hole (perforation)

Ringing in the ears.

Bleeding from the ear.

Prevention

Use wax-softening drops or oil twice a week, or according to the manufacturer's instructions.

Avoid cleaning the ear canals with cotton buds or fingertips, as any object poked into the ear can compact the wax.

Limit ear cleaning to the outer ear only.

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