Ear Wax and Cerumen Impaction
Guest: Dr. Ted Meyer – Otolaryngology/Head & Neck Surgery, MUSC
Host: Dr. Linda Austin – Psychiatrist, MUSC
Dr. Linda Austin: I’m Dr. Linda Austin. I’m talking with Dr. Ted Meyer, who is Assistant Professor of Ear, Nose, and Throat; Otolaryngology, here at the Medical University of South Carolina. Dr. Meyer, I know you see all sorts of things as an ENT doctor. Surely one of the most common presenting symptoms turns out to be something we think of as relatively simple; wax in the ear. How common is that?
Dr. Ted Meyer: Cerumen, or wax, in the ear is universal. Everybody has wax in the ear. It’s normal. You’re supposed to have wax. A high percentage of patients tell me, my ears just make too much wax. The majority of those patients actually have a normal amount of wax, but they see it when they clean their ears with Q-tips, or Kleenex, or things like that. We have to clean a lot of wax out of patients’ ears before hearing tests, or before just looking in their ear for other problems.
Cerumen impaction in my practice, which is strictly for patients who have ear problems, is actually quite common. Cerumen impaction in the general population is also common. Your ear feels stuffed up. Your ear may be wringing. You can’t hear as well on one side as opposed to the other. This can be a serious problem, like Meniere’s disease, or sudden sensorineural hearing loss, or something like that. But most often, thankfully, it’s just a cerumen impaction.
Dr. Linda Austin: Wax must have a normal function in the ear. There must be a reason why the body produces it. Why is that?
Dr. Ted Meyer: I don’t know exactly, but if I had to guess, it would be some sort of protective mechanism. It could be as simple as keeping bugs out of the ears.
Dr. Linda Austin: Yeah; something relatively simple. What are some simple over-the-counter remedies for those who are prone to waxy buildup?
Dr. Ted Meyer: Simple things over-the-counter are mineral oil, or sweet oil, or olive oil; some natural oil, just to soften the wax up. This often helps it move out a little bit quicker, or at least keeps it soft, and keeps it from becoming hard and crusty.
Patients will often stick Q-tips in their ears and get a little bit of wax out, and think they’re cleaning their ears. Q-tips should not go in the ear. The vast majority of times, if you stuck a Q-tip in your ear, it would come out with a little bit of wax on it. But unfortunately, I see the patients who’ve stuck the Q-tip in too far, and it’s gotten stuck. Or even, every year or so, a patient comes in who has stuck a Q-tip in the ear and caused either a hole in the eardrum, or permanent hearing loss. And that’s a terrible thing to have happen.
Dr. Linda Austin: Normally though, people do that routinely without a problem. I mean, if you’re gentle and careful, isn’t that just part of normal hygiene?
Dr. Ted Meyer: If you’re gentle and careful, and stay on the outside, and don’t put the Q-tip in too far, that’s a reasonable thing to do. And along that line, the vast majority of the time when we talk on our cell phones in the car, we don’t get in car accidents. But that doesn’t mean it’s safe to drive while you’re talking on the cell phone.
Dr. Linda Austin: How should one clean one’s ears then, if not with a Q-tip?
Dr. Ted Meyer: I would allow the ear to clean itself. The skin of the ear canal is different than any skin on the body. The skin on your hands, or on your arms and legs, just sloughs away and flakes off. Skin of the ear canal, if it did that, would be filled with skin and debris. So, the ear canal skin actually grows from the eardrum and migrates out the ear canal, normally taking wax and hair, and other things with it. The ear is designed to clean itself. And in the vast majority of patients, it does.
Dr. Linda Austin: So you really don’t have to do anything?
Dr. Ted Meyer: You don’t usually have to do anything, correct.
Dr. Linda Austin: Who knew? Thank you so much for talking with us today.
Dr. Ted Meyer: Thank you.
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