31 Jan 2013

Ear wax, also called cerumen, is something that we all have.

As part of many hearing screening consultations, we’re often asked about ear wax management so we decided to write about it, its amazing properties and give you some background and anatomy of a typical ear canal.

The human ear canal is the only skin-lined cul-de-sac in the body. This S-shaped tube leads from the pinna (the outer ear) to the eardrum. It has the diameter of a pen and is about 2.5 to 3cm long.  The outer half to two thirds of the ear canal is made of cartilage and the remaining is bone.

One to two thousand cerumen (earwax) producing glands line the outer third of the ear canal. Cerumen lubricates the skin in the ear canal and acts as a water repellent.  It discourages fungal and bacterial growth and traps dust and small foreign bodies keeping them from getting into the middle and inner ear.

Cerumen can be classified as dry or wet.  The dry type is often flaky and usually ranges in colour from light yellow to a light brown.  The wet type is divided into hard and soft.  The soft type is frequently found in children.  The hard type is most often observed in patients with cerumen impactions.

Cerumen impactions are the most common cause of conductive (not permanent) hearing loss in adults but it can cause up to 40 dB of hearing loss (more than a pair of tightly fitting earplugs).  The incidence of cerumen impactions varies with age.  In normal young adults the incidence is around 5%, while in the older population (>65 years) the incidence is as high as 34%.  The reason for this high percentage is that there are fewer active cerumen glands and coarser hair follicles so the wax tends to be drier and the coarser hair follicles tend to trap the cerumen.  This results in more frequent cerumen accumulations and more regular visits to your GP or Audiologist.

Because the skin in the ear canal grows from the eardrum out it is best to try and avoid removing your own cerumen, you are highly likely to push it back in and cause a cerumen compaction and/or dry and itchy ear canals!

Finally, cerumen and the ear canal has some wonderful protection properties. Leave it to your GP or audiologist to clean it out and remember the old saying: “Don’t stick anything smaller than your elbow into your ear canal.” Leave it to the experts!

Article written by Kellie M. Walker, Audiologist.

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