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Never put anything smaller than your elbow in your ear! Cotton
swabs are for cleaning bellybuttons-not ears. You have probably
heard these admonitions from relatives and doctors since childhood...read
on to find out what they meant.
The outer
ear is the funnel-like part of the ear you can see on the side
of the head, plus the ear canal (the hole which leads down to
the eardrum).
The ear canal is shaped somewhat like an hourglass-narrowing
part way down. The skin of the outer part of the canal has special
glands that produce earwax. This wax is supposed to trap dust
and dirt particles to keep them from reaching the eardrum. Usually
the wax accumulates a bit, dries out and then comes tumbling
out of the ear, carrying dirt and dust with it. Or it may slowly
migrate to the outside where it can be wiped off. The ear canal
may be blocked by wax when attempts to clean the ear push wax
deeper into the ear canal and cause a blockage. Wax blockage
is one of the most common causes of hearing loss.
Wax is not formed in the deep part
of the ear canal near the eardrum, but only in the outer part
of the canal. So when a patient has wax blocked up against
the eardrum, it is often because he has been probing his ear
with such things as cotton-tipped applicators, bobby pins, or
twisted napkin corners. These objects only push the wax in deeper.
Also, the skin of the ear canal and the eardrum is very thin
and fragile and is easily injured.
Earwax is healthy in normal amounts and serves to coat the skin
of the ear canal where it acts as a temporary water repellent.
The absence of earwax may result in dry, itchy ears.
Most of the time the ear canals are self-cleaning; that is,
there is a slow and orderly migration of ear canal skin from
the eardrum to the ear opening. Old earwax is constantly being
transported from the ear canal to the ear opening where it usually
dries, flakes, and falls out.
Under ideal circumstances, you should never have to clean your
ear canals. However, we all know that this isn't always so. If
you want to clean your ears, you can wash the external ear with
a cloth over a finger, but do not insert anything into the ear
canal.
- partial hearing loss, may be progressive
- tinnitus, noises
in the ear
- earache
- fullness in the ear or a sensation the ear is plugged
Most cases of earwax blockage respond to home
treatments used to soften wax if there is no hole in the eardrum.
Patients can try placing a few drops of mineral oil, baby oil,
glycerin, or commercial drops, such as Debrox®, or Murine® Ear
Drops in the ear. These remedies are not as strong as the prescription
wax softeners but are effective for many patients. Rarely,
people have allergic reactions to commercial preparations.
Detergent drops such as hydrogen peroxide or carbamide peroxide
may also aid in the removal of wax. Patients should know that
rinsing the ear canal with hydrogen peroxide (H2O2) results
in oxygen bubbling off and water being left behind; wet, warm
ear canals make good incubators for growth of bacteria. Flushing
the ear canal with rubbing alcohol displaces the water and
dries the canal skin. If alcohol causes severe pain, it suggests
the presence of an eardrum perforation.
If you are uncertain whether you have a hole (perforation or
puncture) in your eardrum, consult your physician prior to trying
any over-the-counter remedies. Putting eardrops or other products
in your ear in the presence of an eardrum perforation may cause
an infection. Certainly, washing water through such a hole could
start an infection. In the event that the home treatments discussed
in this leaflet are not satisfactory, or if wax has accumulated
so much that it blocks the ear canal (and hearing), your physician
may prescribe eardrops designed to soften wax, or he may wash
or vacuum it out. Occasionally, an otolaryngologist (ENT specialist)
may need to remove the wax using microscopic visualization.
- perforated eardrum
- middle ear infection (otitis media)
- external ear infection
(otitis externa)
- acoustic trauma
© 2004 AAO-HNS/AAO-HNSF
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