cerumen impactation (obstruction)
Jump to navigation
Jump to search
Etiology
(risk factors)
- hearing aids
- excessive ear canal hair
- benign bony growths in the ear canal
Pathology
- external auditory canal may be completely occluded
- conductive hearing loss
Clinical manifestations
- acute unilateral hearing impairment
- gradual hearing impairment
- dizziness
- pain or itching
- chronic cough
Diagnostic procedures
- Weber test:
- with conductive hearing loss, sound is perceived as greater in the affected ear
- Rinne test:
- generally normal because cerumen impactation is associated with mild conductive hearing loss
- ONLY when conductive hearing loss becomes moderate (not mild) does sound heard via air conduction vs bone conduction become closer to 1:1[5]
Management
- see ear wax removal
- peroxide-based otic (cerumenolytic)[5]
- ear irrigation* (water or saline at room temperature)[5]
- indications
- patient is symptomatic[4]
- evaluation of the tympanic membrane[1]
- indications
- manual removal with instrumentation[4]
- clinical observation
* ear irrigation is indicated only if patient is symptomatic or it is necessary to visualize tympanic membrane[1]
Notes
More general terms
Additional terms
References
- ↑ 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16, 17. American College of Physicians, Philadelphia 1998, 2009, 2012, 2015
- ↑ Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ Roland PS, Smith TL, Schwartz SR et al Clinical practice guideline: cerumen impaction. Otolaryngol Head Neck Surg. 2008 Sep;139(3 Suppl 2):S1-S21 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18707628
- ↑ 4.0 4.1 4.2 Schwartz SR, Magit AE, Rosenfeld RM Clinical Practice Guideline (Update). Earwax (Cerumen Impaction) Otolaryngol Head Neck Surg. 2017 Jan;156(1_suppl):S1-S29 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28045591 <Internet> http://journals.sagepub.com/doi/full/10.1177/0194599816671491
- ↑ 5.0 5.1 5.2 5.3 5.4 NEJM Knowledge+ Otolaryngology