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Wax blockage

Definition

Wax blockage is an obstruction of the ear canal with wax (cerumen).

Alternative Names

Ear impaction; Cerumen impaction; Ear blockage; Ear wax

Causes, incidence, and risk factors

The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen.

Ear wax protects the ear by trapping dust, bacteria and other microorganisms, and other foreign particles to prevent them from entering and damaging the ear. Ear wax also helps protect the delicate skin of the ear canal from becoming irritated when water is in the canal. The wax usually makes its way to the opening of the ear, where it falls out or is removed by washing.

In some people, the glands produce more wax than can be easily removed from the ear. This extra wax may harden in the ear canal and block the ear. More commonly, wax may block the ear canal if you try to clean the ear and accidentally push wax deeper into the ear canal.

Wax blockage is one of the most common causes of hearing loss.

Symptoms

  • Earache
  • Fullness in the ear or a sensation that the ear is plugged
  • Noises in the ear (tinnitus)
  • Partial hearing loss, may get worse

Signs and tests

During a physical examination, the health care provider will look into the ear for signs of wax blockage.

Treatment

Most cases of ear wax blockage can be treated at home. The following can be used to soften the wax in the ear:

  • Baby oil
  • Commercial drops
  • Glycerin
  • Mineral oil

Detergent drops such as hydrogen peroxide or carbamide peroxide may help remove the wax.

Another method of removing wax is called irrigation. Use body-temperature water (cooler or warmer water may cause brief but severe dizziness or vertigo). With your head upright, straighten the ear canal by holding the outside ear and gently pulling upward. Use a syringe to gently direct a small stream of water against the ear canal wall next to the wax plug. Tip your head to allow the water to drain. You may need to repeat irrigation several times.

Never irrigate the ear if the eardrum may not be intact. Irrigation with a ruptured eardrum may cause ear infection or acoustic trauma. Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik) because the force of the irrigation may damage the eardrum.

After the wax is removed, dry the ear thoroughly. You may use a few drops of alcohol in the ear or a hair dryer set on low to help dry the ear.

If you cannot remove the wax plug or irrigation causes discomfort, consult a health care provider, who may remove the wax by:

  • Repeating the irrigation attempts
  • Suctioning the ear canal
  • Using a small device called a curette

Occasionally, the wax must be removed with the help of a microscope.

Expectations (prognosis)

Wax blockage of the ear usually responds well to removal attempts. However, it may happen again in the future. Hearing loss is usually temporary. Hearing usually returns completely after the blockage is removed.

Complications

Calling your health care provider

Call for an appointment with your health care provider if your ears are blocked with wax and you are unable to remove the wax.

Also call if you have an ear wax blockage and you develop new symptoms, especially:

Prevention

People who have frequent blockages may benefit from weekly irrigations. Never attempt to clean the ear by placing any object into the ear canal, such as a Q-tip. It is better to clean the outer ear canal by using a cloth or paper tissue wrapped around your finger.

References

Riviello RJ, Brown NA. Otolaryngologic procedures. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 64.

Armstrong C. Diagnosis and management cerumen impaction. Am Fam Physician. 2009 Nov 1;80(9):1011-1013.

House JC, Lee DJ. Topical therapies of external ear disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 138.


Review Date: 8/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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