Friday, August 16, 2013

Ear wax removal: How to treat ear wax

Trina Remedios, Health Me Up
Ear wax build up either twitches your nose or tickles the ear. Dr. B. M. Abrol, Consultant ENT Specialist at Pushpawati Singhania Research Institute, New Delhi tells us everything that we should know about ear wax. He explains what ear wax is, what causes it and how to remove and treat it.

What is ear wax?
Ear wax is medically referred to as cerumen. Dr B. M. Abrol explains this waxy substance, "It is produced in the outer cartilaginous part of the ear canal by the secretions of cerminous glands and is usually soft and brownish in colour. To this are added secretions of Hilo sebaceous glands and desgumented cells of the skin of the outer ear canal which makes it hard and dark chocolate coloured."

You may have noticed that the wax appears in different consistency, the ENT Specialist elaborates on this, "The consistency of wax is determined by the proportions of this mixture. The soft wax in small amounts is helpful as a lubricant, as it catches dust and bacteria. It also has the enzyme, Lysozyme which kills bacteria."

Risks of excess ear wax
What happens when ear wax hardens? ENT Specialist from Pushpawati Singhania Research Institute informs, "When wax becomes hard, it causes pressure on the skin lining of the outer ear canal necrosis of superficial cells of skin and becomes painful when nerve endings are exposed due to pressure on necrosis or rubbing of the skin with buds and if water enters the ear canal during bath, shower, shampoo or swimming- it may lead to fungal infections of the ear canal especially in summer and rainy season particularly when a person uses oil or oily drops in ears as it prevents moisture to evaporate."

Ear wax secretion
Did you know, the movement of your jaw pushes ear wax to the opening of the ear. Dr B. M. Abrol states that, "Normally, the wax is expelled from the ear canal in flakes, scales or small balls which is aided by the movements of the lower jaw, located in the front of the ear canal. A wax plug or hard wax happens, when there is an excessive formation of wax."

Symptoms of ear wax:
1.    Impaired hearing and a blocked ear canal.
2.    Itching, when the wax is hard and messes on the skin and nerves of our ear canal.
3.    Tinnitus (noise in the ear), earache, vertigo and reflex cough may also occur.

The symptoms are sudden and severe when a plug of wax is pushed in by buds, which are thick and hard, as the ear get infected against the tympanic membrane.

How often should one use a ear bud to clean ear wax?
This is one question that everyone wants answered. The doctor says, "In my opinion never, as it removes the superficial brownish soft wax and pushes most of the wax deeper into the drum membrane and increases the blockage of the ear."

Treatment for ear wax

  1. Syringing with sterile water at body temperature: Usually removes wax but should not be done forcefully and with great pressure as it can damage the ear drum and ear canal. This is contraindicated if there is a perforation (hole) in the Tympanic membrane. Precautions: a) Must use sterile warm water at body temperature. b) Dry the excess moisture with sterile cotton swabs or suction cleaning.
  2. Removal with of wax with forceps, hooks and probes: They may be helpful in the removal of large masses as one piece, as broken bits can cause injuries to the skin of the outer ear canal. One must be cautious when the patient is on blood thinners as it can cause bleeding while cleaning.
  3. Cleaning by suction (vaccum)- through examination under microscope is the safest and best method to remove wax especially when there is a perforation in the drum or in children.

Treatment for ear wax
In case of hard and dry extensive wax, the softening of wax can be achieved by repeated instillation of wax softening ear drops into the outer ear for 3-4 days and then cleaning by suction. Most of the cases can be tackled with an anaesthetic. However, in children and apprehensive adults, one may occasionally have to resort to general anaesthesia.



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