Earwax
Earwax, or cerumen, is a natural substance produced in the outer third of the ear canal, consisting of a blend of dead skin cells, sebum, and wax secreted by specialized glands. It exists in two primary forms: wet and dry, with genetic factors influencing this characteristic. The primary function of earwax is to protect the ear by trapping dust, bacteria, and other foreign particles, facilitating their gradual movement out of the ear canal due to jaw movements during chewing and speaking.
While earwax serves a protective role, an imbalance—either too much or too little—can lead to health issues. Excess earwax can result in blockages, hearing loss, or infections, while insufficient earwax may compromise ear protection. Symptoms of excessive earwax, known as cerumen impaction, include hearing loss, earache, and a sensation of fullness in the ear. Cleaning earwax should be approached cautiously; attempting to remove it with cotton swabs or other objects can push it further into the ear and potentially cause damage. For safe removal, a healthcare professional can employ specific tools or techniques, including cerumenolytic agents or irrigation, ensuring a thorough and safe process.
Subject Terms
Earwax
Also known as: Cerumen
Anatomy or system affected: Ears
Definition: A normal, waxy product with antibacterial properties that forms in the outer third of the ear canal; protects the ear from water and helps prevent infection
Structure and Functions
Earwax is made of a combination of dead skin cells, sebum (an oily substance produced by sebaceous glands), and a wax that is secreted by special glands in the outer third of the ear canal. There are two basic types of earwax, described as wet or dry; a gene has been identified that determines this characteristic: wet earwax contains more fat.
The function of earwax is to protect the ear by trapping dust, bacteria, and foreign particles. Earwax moves out of the ear canal to the ear opening, where it becomes dry and falls out. This action is assisted by the motion of the jaw during chewing and speaking.
Disorders and Diseases
Too much or too little earwax can both increase the possibility of infection. Too little earwax compromises the protection of the ear from bacteria and foreign particles. Too much earwax can trap bacteria in the ear and cause infection, plug the ear and cause some loss in hearing, or cause a blockage that does not allow a doctor to adequately see the outer and middle ear canal during examination.
Symptoms of a wax blockage, called cerumen impaction, can be a decrease in hearing, an earache, a feeling of fullness in the ear, or a feeling that the ear is plugged. When individuals probe or try to clean out their own ears using a cotton swab or other device, such as a hairpin, this often pushes the wax deeper into the ear and can cause wax blockage against the eardrum and possible perforation of the eardrum.
The best method for earwax removal is by a doctor using a device, a microscope or an otoscope, to see a lighted and magnified view of the outer and middle ear; earwax can then be removed using a cerumen spoon or with forceps or mild suction. Other methods of earwax removal by a doctor include use of a cerumenolytic agent (a wax softener) or by irrigation of the ear with water. Over-the-counter irrigation products for individuals to use at home are available, but some studies have shown that water is as effective as these products. Other do-it-yourself products for earwax removal, including vacuum kits and “candling,” where a cone-shaped device is put in the ear canal and lighted at the outside end to draw wax and impurities from the ear, are strongly discouraged.
Bibliography
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