Blockage of the ear canal with cerumen (wax).

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. This protects the ear by trapping dust, microorganisms, and foreign particles and prevents them from entering and damaging the ear. 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 excreted out the ear. This extra wax may harden within the ear canal and block the ear. More commonly, the ear canal may be blocked by wax when attempts to clean the ear push wax deeper into the ear canal and causes a blockage. Wax blockage is one of the most common causes of hearing loss .

Signs and tests

An examination of the ear shows blockage by wax.

Treatment

Most cases of ear wax blockage respond to home treatment. Mineral oil, baby oil, glycerin, or commercial drops can be used to soften wax in the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide may aid in the removal of wax. Another method to remove wax is irrigation of the ear. Body-temperature water should be used (cooler or warmer water may cause a response consisting of brief but severe dizziness or vertigo ). With the head upright, straighten the ear canal by holding the external 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 the head to allow the water to drain. Irrigation may need to be repeated several times. Never irrigate the ear if the eardrum is not known to be intact, because 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, the ear should be dried thoroughly. A few drops of alcohol in the ear or a hair dryer set on low may be used to aid in drying. If attempts to remove the wax plug are unsuccessful, consult the health care provider, who may remove the wax by repeating the irrigation attempts, suctioning the ear canal, or removing wax with a small device (curette). Occasionally, the wax must be removed with microscopic visualization.

Expectations (prognosis)

Wax blockage of the ear usually responds well to removal attempts, but may recur. Hearing loss is usually temporary and recovery after removal of the blockage is usually complete.

Complications

Calling your health care provider

Call for an appointment with your health care provider if the ears are blocked with wax and attempts to remove the wax are unsuccessful. Also call if earwax blockage has been present and new symptoms develop, especially drainage from the ear , persistent or severe ear pain , fever , or persistent hearing loss .

Prevention

Do not attempt to clean the ear by placing any object into the ear canal. Wash the external ear with a cloth over a finger but do not insert anything into the ear canal.