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Key Points
Î Cerumen forms when glandular secretions from the outer two-thirds of
the ear canal mix with exfoliated squamous epithelium.
Î Normally, cerumen is eliminated or expelled by a self-cleaning
mechanism, which causes it to migrate out of the ear canal assisted by
jaw movement.
Î Blockage of the ear canal from cerumen can lead to a host of
symptoms including: hearing loss, tinnitus, fullness, itching, otalgia,
discharge, odor, or cough.
Î In addition, cerumen impaction can prevent diagnostic assessment by
preventing complete examination of the external auditory canal and/
or ear drum (tympanic membrane) or by interfering with diagnostic
assessment (i.e. audiometry, tympanometry).
Î Asymptomatic cerumen does not require active management.
Î This guideline does not apply to patients with cerumen impaction
associated with the following conditions: dermatologic diseases of the
ear canal, recurrent otitis externa, keratosis obturans, prior radiation
therapy affecting the ear, previous tympanoplasty/myringoplasty or
canal wall down mastoidectomy or other surgery affecting the ear
canal.
