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Cerumen Impaction Pocket Guideline

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2 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.

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