![]() Another common reason to remove cerumen is to facilitate audiometric examination, which often includes immittance tympanometry, and this cannot be performed in the presence of complete external auditory canal occlusion because it involves using air pressure pulses to calculate the volume of the external auditory canal and the compliance of the tympanic membrane. The inability to examine an ear by otoscopy, particularly an ear with other symptomatology, such as hearing loss, tinnitus, pain, or vertigo, due to cerumen impaction is also an indication for cerumen removal. Similarly, placing cotton swabs into the ear canals to address pruritus is liable to increase cerumen production and exacerbate the itching.Īlthough excessive accumulation of cerumen is typically asymptomatic, patients should be treated if they present with hearing loss, ear fullness, pruritus, dizziness, tinnitus, or otalgia. While there is a certain baseline rate of cerumen production, frequent insertion of foreign objects into the external auditory canal, such as cotton swabs and certain types of hearing aids or earbuds, will often accelerate the production of cerumen and potentially change its composition. ![]() In one study, every sample of cerumen from patients with recurrent impactions showed evidence of fungal growth, most commonly Aspergillus terreus when bacteria are present, Staphylococcus aureus is most common. Impacted cerumen may also contain neutrophils and has a much higher likelihood of bacterial or fungal colonization. The composition varies somewhat, with harder cerumen containing relatively more keratin than softer cerumen. ![]() More specifically, long-chain saturated and unsaturated fatty acids, alcohols, squalene, and cholesterol make up the acellular component. Keratin from shed skin cells accounts for roughly 60% of cerumen's mass, with the remainder composed of lipids and peptides secreted by the sebaceous and ceruminous glands of the lateral third of the external auditory canal. It is most often diagnosed by direct visualization by a trained clinician using an otoscope but may require more complex equipment, such as an operating microscope, for removal. It can interfere with tympanic membrane examination as well as audiometry and hearing aid fitting. In the United States, it leads to 12 million patient visits and eight million cerumen removal procedures each year. Įxcessive buildup of cerumen is likely underdiagnosed and undertreated. It is often seen in patients who routinely wear hearing aids or earplugs and those with exostoses or anatomic abnormalities of the external ear canal. Cerumen impaction is the most common ear complaint of patients to clinicians in the United States, occurring in up to 6% of the general population, affecting 10% of children and greater than 30% of the elderly and cognitively impaired. Ĭerumen impaction can occlude the external auditory canal or press against the tympanic membrane, potentially causing ear fullness, conductive hearing loss, itching, and pain. However, this automatic clearing mechanism fails in specific individuals, and cerumen can become caught and impacted. Cerumen is typically expelled from the ear canal spontaneously as a result of normal jaw movement. Cerumen moisturizes the skin of the external auditory canal and protects it from infection, providing a barrier against the intrusion of water, foreign bodies, and even insects and other arthropods. Production of cerumen (earwax) is a normal biological process in humans and many other mammals.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |