earwax or ear canal (Earwax or medical term called Cerumen) arises from the gland that produces earwax (Ceruminous gland) located between the outer ear canal (External ear canal) and the eardrum (Eardrum). Will flow through the ear canal slowly, combined with the fat produced by sweat glands (Sebaceous gland), skin or ear mucosa that peels off (Ketatin), dust and sweat become earwax. By nature, earwax is pushed out of the ear canal at least a day. by the movement of epidermal cells that cover the outer ear Therefore, we do not need to use any method of picking, rake or cleaning in the ear canal.
Earwax is not just a simple scab because it has an important function.
as a disinfectant poopThe ear has a weak acidic property that can destroy bacteria that invade the ear canal. This helps prevent infection of the ear canal wall and spread to the middle and inner ear.
Prevent foreign objects from entering the ear such as insects, debris, or dust that may penetrate into the ear canal
It helps to keep the ear wall lubricated and moist to prevent inflammation. In winter, the skin tends to become dry, flaky, white due to low humidity. The skin is dry, cracked and itchy, so you may need to apply a cream to help. But the skin in the ear canal is much thinner than normal skin. Therefore, the oil must be coated all the time. Otherwise, it may dry out and cause infection.
Earwax is divided into two types: dry earwax (Dry cerumen) andwet earwax (Wet cerumen), where wet earwax contains more fat and pigment than dry earwax. Therefore, it is tough and has a darker color. It is also believed that different nationalities It may also cause different earwax characteristics. For example, most yellow-skinned people and Indians have dry earwax. But most whites and blacks have wet earwax. The amount of earwax in each person is different.
earwax clogging the ear canal Cerumen impaction or earwax blockage is a common condition in the ENT department. It can be found in patients of all ages. There is no definitive case regarding the incidence of earwax obstruction. But it is reported to be found in about 10% of all children, about 5% in adults, and up to about 57% in the elderly.
Causes of earwax blockage
Most often this is caused by cleaning the ear canal too often. For example, using ear picks, cotton swabs, matchsticks, or other ear-picking tools (especially after bathing Then there is water in the ear that makes me feel annoyed), which these actions will cause irritation or inflammation. stimulates the glands to produce earwaxproduce more earwax Therefore, the accumulation of earwax is a solid lump and clogs the ear canal. In addition, cleaning in such a way also pushes the earwax deeper. Into the accumulation of clogged deeper inside as well.
There are also other risk factors for earwax blockage, including:
Anatomical features of the ear canal, such as a narrow ear canal
Disproportionate components of the earwax, such as the presence of a large amount of skin or mucous membrane of the ear canal (Ketatin), harden the earwax and make it difficult to move out of the ear canal. therefore easily clogged abnormally high production of earwax from a state of excessive sweating or in a place where there is a lot of dust all the time
Regular use of headphones or hearing aids, which will cause irritation to the lining of the ear canal. thus creating more earwax
Ear canal skin disorders, such as Keratosis Obturans, which is caused by abnormal division of skin cells or the lining of the ear canal. Therefore, the earwax contains more keratin (Keratin), which makes the earwax hard and adheres to the ear canal. If left for a long time, erosion of the ear canal wall may occur. In addition, the disease can also cause inflammation and infection of the ear canal.
Symptoms of earwax blockage
Patients will have ear itching, pain or dull pain in the ear canal with tinnitus. decreased hearing, ringing in the ears, or ringing in the ears (caused by the movement of earwax)
Hearing noise is caused by a large amount of earwax clogging the ear canal and preventing it from falling out on its own. Especially when earwax swells from getting wet. or is the earwax that clumps together A blocked earwax can give the patient a dull sensation in the ear canal if left untreated until the symptoms worsen. It may cause deafness. can’t hear clearly or a ringing sound in the ear
Tinnitus is usually only on one side. This occurs suddenly after swimming, bathing or washing your hair, as the accumulated earwax carries water that enters the ear canal. until the earwax swells and is packed in the ear canal In some cases, it may feel like there is a dew in the ear all the time. When I tried to wipe it off with a cotton swab But the more you wipe it, the louder it gets. This is because wiping the earwax in this way tends to push the wax deeper and more tightly packed. and some may have ear pain or dizziness
Complications of earwax obstruction
By nature, earwax tends to fall out of the body on its own while talking or chewing food. Using your fingers, ear picks, cotton buds, matchsticks, or other devices to pick up the ears, thus pushing the earwax deeper into the deep clots. more inside It also stimulates the earwax glands to produce more earwax, which may lead to a blockage. Therefore, we should not pick the ear in any way. In addition, the ear picking can also cause the eardrum to be wounded or perforated. or cause the already delicate ear canal to scratch easily When abrasions or wounds occur, the lining of the ear canal will secrete histamine. cause itchy ears (The more you scratch your ears because of itching, the more severe the symptoms.) This can lead to a bacterial or fungal infection. Otitis externa can cause otitis externa (patients will have tinnitus, ear pain and purulent discharge). to wait for the skin to return to its normal state
Diagnosis of earwax blockage
The doctor will use an instrument called an otoscope to look at the outer ear canal. This will help to see if there is a blockage in the ear canal or not. This is an easy and painless way. In the case of earwax obstruction will find earwax clogged in the ear canal until the eardrum is not visible because it was covered by earwax
How to treat earwax blockage
When suspected of having a blocked earwax causing ear disorders such as tinnitus, ear pain, decreased hearing (Especially the tinnitus that occurs suddenly after swimming or having water in the ear. and live for days) If possible, you should see an ear, nose and throat specialist to diagnose and differentiate from other conditions such as otitis externa from infection. acute ear infection This is because these conditions are more severe than earwax blockages. This requires specific treatment to prevent complications such as permanent hearing loss.
In the event that the doctor has diagnosed a patient with earwax blockage If the light is visible in the ear canal Earwax is seen to be quite loose, not very tight. The doctor will take the earwax out to restore the patient’s hearing. The earwax may be used to suck the earwax (Suction), tongs or pick up with medical tools. (Ear-hook or ear-hook) Gently shake the earwax out. But if you can’t get rid of it or your earwax is hard The doctor will use normal saline or clean water mixed with sodium bicarbonate with a temperature of 37 ° C. Wash it off (avoid using water below or above 37 ° C because it may encourage the patient to develop dizziness)
If it still doesn’t work, the earwax can’t be removed or only part of the earwax can be removed. or in cases that are seen as hard earwax or very tightly packed earwax or get hurt The doctor won’t try to pick it up right away, but will order it.earwax solution (Cerumenolytic agents) such as olive oil or 2.5% NaHCO solution3 Have the patient return to the ear for repeated instillation 7-8 times a day for 3-7 days. to soften the earwax first Then the doctor will make an appointment to see again. Patients should not forget to instill the ear on the day of the doctor’s appointment. This will dry out the earwax and be difficult to remove. And if possible, while waiting in line to see the doctor, you should also put some ear drops in it. so that the doctor can remove the earwax more easily By using normal saline spray to wash out the earwax.
In cases where infectious inflammation occurs Similar to Otitis exterma, your doctor will treat you with pain relievers and antipyretics, such as dicloxacillin. (Dicloxacillin) or erythromycin (Erythromycin) and may also be given antibiotic ear drops 3-4 times a day, more than 5 drops each time, etc.
After the doctor has successfully removed the earwax and has relieved the symptoms of ear disorders. should prevent the earwax from becoming blocked again by
Never use a cotton swab to clean your ears or spin them again. But if you are afraid that the water will get into your ears and cause nuisance Should be prevented by using a cotton ball moistened with vaseline. or use earplugs for divers (Available at sporting goods stores) to plug in your ears while taking a shower. or in a woman wearing a shower cap Should pull a hat to cover the ears to prevent water from entering the ears, for example.
Earwax softeners may be used on a regular basis to clear the earwax. It may only be used once a week. And if there is no problem, it may be used 2, 3, or 4 weeks apart. This will greatly reduce the clogging of the earwax in the outer ear canal.
advice : If you use a light, you can’t see the earwax clearly. Don’t try to pick up, scratch your earwax, or use water to rinse it out.
How to prevent earwax blockage
Should stop the habit of picking ears, wash the ears and should not use a cotton swab to wipe or spin the ears regularly. because besides it is not as useful as it should be It may also encourage more earwax to clog the ear canal or cause other harm as mentioned above.
Proper ear cleaning should only be to clean the outer ear. If something is needed to pick up the ear, it should be your finger gripped with a clean cloth or cotton swab in the ear canal. (without sticks or stingers) as deep as the fingers can enter is enough. and don’t go any deeper than that But if you want to use the finished cotton swab, please use it to wipe only the ears or in the nooks and crannies. Because it can cause harm and cause earwax blockage as a result.
To prevent repeated blockage of earwax Mostly when the earwax has been removed Patients will feel that their hearing improves. The recurrence of each individual is not the same. Because it depends on the risk factors of each patient, such as if the ear canal is abnormally narrow. Requires regular use of hearing aids or a disease of the skin in the ear canal. Therefore, those in this risk group if there is tinnitus occurs. You should immediately see a doctor to remove the earwax. Because it is difficult for the patient to clean the ear canal by himself. and can cause injury to the ear canal For those who are not in the risk group but are caused by hard earwax. You should consult a doctor specializing in the ear, nose and throat on how to take care of yourself. You should never buy ear drops or use any other ear-picking method without consulting your doctor first.
Textbook of general medical examination 2. “earwax clogging the ear canal (Wax blockage/Impacted cerumen)”. (Dr. Surakiat power Pages 926-927.
Department of Otolaryngology, Faculty of Medicine Siriraj Hospital Mahidol University “Earwax clogged…what should I do?”. (Assoc. Prof. Dr. Paraya Asanasen). [ออนไลน์]. Can be accessed from : www.si.mahidol.ac.th. [23 ส.ค. 2016].
Village Doctor Foundation. Village Doctor Magazine, Volume 85, Column: Interesting Facts. “earwax, earwax, earwax”. (Dr. Jinda Pharak). [ออนไลน์]. Can be accessed from : www.doctor.or.th. [25 ส.ค. 2016].