Finally, Guidelines On Cleaning Ears Released

Some 12 million people a year seek medical treatment for impacted earwax. Now, the American Academy of Otolaryngology–Head and Neck Surgery Foundation is releasing clinical guidelines on the management of earwax impaction.

The guidelines suggest that patients and doctors keep in mind that earwax, technically known as cerumen, is a beneficial, self-cleaning agent with protective properties. It should be removed only when it builds up to a point where it causes symptoms such as pain or hearing loss.

Appropriate options for physicians to treat cerumen impaction are:

• cerumenolytic (wax-dissolving) agents, such as water or saline

• irrigation or ear syringing, a procedure that involves a clinician injecting a stream of water into the ear canal.

• manual removal with special instruments or a suction device

Inappropriate or harmful interventions are:

• inserting cotton-tipped swabs into the ear canal

• oral jet irrigators, such as a Waterpik

• ear candling, a technique that involves inserting a paraffin coated tube into the ear and then lighting it

There are no proven ways to prevent cerumen impaction, but not inserting cotton-tipped swabs or other objects in the ear canal is strongly advised. Individuals at high risk, e.g., hearing-aid users, should consider seeing a clinician every six to 12 months for routine cleaning.

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