Understanding Ear Wax

By Jonathan R. Brown, PhD, CCC-A, CED

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Cerumen, pronounced "sa-roo-men" and commonly called earwax, is a sticky liquid secreted by glands in the ear canal. Although cerumen can help protect the canal area from the outer ear to ear drum, sometimes it builds up, obstructs the canal and blocks sounds from reaching the eardrum. Therefore, it is important to be sensitive to sensations of an ear feeling as if it is "plugged" or not as sensitive to sounds as usual. If that happens, it is important to consult an audiologist or physician.

Sometimes people try to remove earwax by using cotton-tipped sticks or other probing instruments, but using inappropriate instruments and inappropriate techniques may cause serious damage to the ear canal and/or ear drum. It is best to seek the help of a professional hearing specialist.

Your audiologist will begin to help you by gathering information about your ear and histories of hearing, surgical procedures, treatments, medications (especially blood thinning medications), and infectious diseases. Individual patient healthcare is very important. Depending upon your responses to initial questions, more information may be gathered and/or a referral may be made to another specialist.

Then the audiologist will examine the inside of your ear with an otoscope, a lighted, handheld instrument with a magnification lens. The otoscopic examination doesn't hurt; the audiologist simply looks in the ear canal for anatomical irregularities, structural problems, irritations, inflammations, perforations, and the amount and distribution of cerumen.

When an unusual amount of cerumen is found, if no other problems have been noted that would require the services of another specialist, a cleaning process may be initiated. While some professionals will prescribe ear drops to help soften the wax for natural removal, many professionals clean the obstructed canal during the office visit. To begin the in-office procedure, the patient is first draped or covered to protect clothing from becoming soiled or wet.

Basic instruments used will include some kind of irrigator, which dispenses water, often mixed with a cleaning solution, to wash out the ear canal. Water temperature is regulated to help ensure patient comfort and effective cerumen removal.

A suctioning device is also frequently used to help extract larger cerumen particles and remove water. Suctioning may sound noisy to a patient, because water is sucked into a small tube inserted into the ear.

Other instruments are also used to help remove cerumen from a patient's ear. Some of these are stainless steel or disposable instruments, such as curettes, spoons and forceps. These instruments are made in different sizes to accommodate varying ear canals and to ensure the patient remains comfortable.

While the risks of cerumen removal are normally small, a patient should be aware of them. For example, abrasions or irritation of the ear canal are possible. When side effects occur, the audiologist will tell the patient what kind of symptoms to expect, such as a possible discharge or sour smell following the procedure. In unusual cases, a physician may be needed to examine and treat the canal irritation.

After an ear canal is cleaned, the last step in a good management program is earwax maintenance. Remember, earwax is a naturally occurring substance needed for a healthy ear. The best practice for maintaining a healthy ear is to talk with your audiologist, who will balance your individual healthcare needs with a prescribed process for maintaining a healthy ear.

Cerumen buildup is a common ear problem. It is important to consult your audiologist if you feel you have an excessive amount of earwax. If it is necessary to remove it, the process normally does not take a lot of time and is generally simple. Experienced audiologists are proficient practitioners and make patients safe and comfortable during the earwax removal procedure. Afterward, cerumen management is one of many ear and hearing management procedures that are important for enjoying life.