TAG | Don’t remove that earwax yourself |
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| by William Atkins | |
| Tuesday, 02 September 2008 | |
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Page 2 of 2 The guidelines also recommend that people with a build up of earwax—to a point that it causes itching, ringing, pain, or hearing problems—should seek out a physician. • "Clinicians should treat cerumen impaction that causes symptoms expressed by the patient or prevents clinical examination when warranted." The following “recommendations” were also made: • "Clinicians should diagnose cerumen impaction when an accumulation of cerumen is associated with symptoms, or prevents needed assessment of the ear (the external auditory canal or tympanic membrane), or both." • "Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as one or more of the following: nonintact tympanic membrane, ear canal stenosis, exostoses, diabetes mellitus, immunocompromised state, or anticoagulant therapy." • "Clinicians should examine patients with hearing aids for the presence of cerumen impaction during a healthcare encounter (examination more frequently than every three months, however, is not deemed necessary)." “Individuals at high risk for cerumen impaction, such as those who wear hearing aids, should consider seeing a clinician every six to 12 months for routine cleaning” [ScienceDaily.com} • "Clinicians should treat the patient with cerumen impaction with an appropriate intervention, which may include one or more of the following: cerumenolytic agents, irrigation, or manual removal other than irrigation." “Wax dissolving agents are effective, but evidence is lacking regarding the superiority of any particular agent” [ScienceDaily.com] “Irrigation or ear syringing is most effective when a wax-dissolving agent is instilled 15 to 30 minutes before treatment” [ScienceDaily.com] “Ear candling, an alternative to traditional methods of ear wax removal, doesn’t work, is potentially dangerous and is condemned by the Food and Drug Administration” [ScienceDaily.com] • "Clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should prescribe additional treatment. If full or partial symptoms persist despite resolution of impaction, alternative diagnoses should be considered." “Manual removal with special instruments under medical supervision is a final option and is preferred for patients with narrow ear canals, eardrum perforation or tube, or immune deficiency” [ScienceDaily.com]
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