WHO HAS EARWAX?

What is it & why is it there? How’s it made?
Does it make you deaf?
What problems does it cause? Should I remove it & how?

What is it & why is it there?
Cerumen – commonly known as earwax – is present in everyone’s ear to a greater or lesser degree. Indeed, it is a very useful natural component of the outer portion of the meatus [ear canal]. It protects physically against damage to the delicate skin lining and trapping dirt plus chemically protecting against infections.

It occurs through the mixing of discarded skin cells and glandular secretions and will only be found in the outer “fleshy” portion of the ear canal unless … you [or some outside force] have pushed it further down the canal to the “bony” portion. Ironically, if left alone it usually migrates out of its own accord, though as the body ages and the skin dries out, the wax can then stick to the surface more easily; similarly if a hearing aid is worn.

How’s it made?
Not only does the ear contain the smallest bones in the body [ossicular chain – malleus, incus & stapes] but it also has a pretty marvellous and mysterious technique whereby the superficial keratin squames [surplus dead skin cells], which owing to the shape and positioning of the ear canal cannot, through friction, dispose of this waste, circumvents the problem through epithelial migration. The outer layer [skin] of the three-layered TM [Tympanic Membrane – ear-drum] moves in a radial motion until reaching the walls of the canal. It then moves laterally until it encounters resistance in the “hairy” part of the canal in the cartilaginous zone [the outer third]. This where it becomes “earwax” as it mixes with the secretions of the cerumen glands [plus associated debris blown in from the outside world]. Talking, laughing, yawning and chewing automatically helps dislodge this wax to drop out of your ear.

Does it make you deaf?
That would depend largely on your definition of “deaf”. My dictionary defines it as partially or totally unable to hear; it doesn’t debate any permanence. So, it does affect your hearing and, therefore under that description, earwax can make you deaf. But it is not a permanent situation; the wax blockage can be removed and, virtually in an instant, your residual hearing is restored. This situation is usually only caused by complete blockage of the auditory meatus [ear canal]. Cerumen can be over-produced in response to infections or loud noises. Some people with abnormally shaped ear canals might encounter build-up. Impacted wax usually causes some degree of loss.

What problems does it cause?
Apart from the afore-mentioned hearing problems, there is a slightly different situation when one has impacted wax. This generally only affects a small percentage of the population and can be caused by a variety of means – constant, inappropriate use of “cotton buds” ramming the wax back into the meatus a bit like the old fusiliers with their muskets. A number of symptoms might be experienced from impacted wax including: tinnitus [ringing in the ear], pain, vertigo [balance problems] itching and/or even a cough.

Another major problem for millions is the effect wax build-up has on them wearing hearing aids. When a custom made aid [or ear-mould] is inserted into a waxy ear it can push the wax further in and thus contributes to the condition previously discussed – impacted wax. More importantly, despite a whole host of ingenious ideas from leading manufacturers on the principle that prevention is better than cure [particularly under warranty repair in their laboratories], it can so easily get inside the sound outlet and, often immediately, stop the aid from working. Very few people using hearing aids, despite the best advice from whomever fitted the aid, actually go through the recommended process for their particular hearing aid to keep it virtually clear of earwax. And, because many of them are so small, which in turn makes the sound outlet extremely tiny; it’s almost impossible with the naked eye to see the slowly encroaching build-up of wax within the hearing aid. Consequently, audiologists are frequently regaled by tales from unhappy users that their hearing aid is broken!

Should I remove it & how?
The simple [yet confusing] answer is Yes and No! “Yes” excess earwax should be removed and “No” you shouldn’t try doing it yourself – at least not with manual insertions of any objects. Let me say here and now do not push cotton buds into your ear canals. As someone once asked me, in response to my last statement, “So why do they make them then?” – my response: they make sharp knives but one does not have to push them into one’s orifices.

It is better to keep one’s ears clear of wax build-up as explained above and, once clear, a weekly spray of clinical olive oil from a product such as Earol will have beneficial preventative assistance in aiding the natural epithelial migration. The ears will retain more elasticity and keep supple with the surface of the skin being smoother allowing easier migration.

There are many products commercially available to assist in removing wax build-up and it is usually a case of “different strokes for different folks” as to which suits whom. Many practice nurses, in preparation for syringing a patient’s ears, will advise using a few drops of oil [Olive or Almond] each day for up to seven days prior to the visit. Unfortunately, they often don’t explain that for this to have a truly beneficial effect it needs to be done one ear at a time; keep the head in a horizontal position with the oiled ear uppermost for at least ten minutes. Otherwise the oil will not have time to penetrate the hard wax and will instead just fill the piece of cotton wool placed in the ear to prevent the oil from escaping.

An E.N.T. consultant surgeon can remove wax in many ways including suction as they have operating microscopes allowing greater insight. One ENT that I know and refer to frequently has issued a list of helpful hints, which includes immersing one’s head in the bath [assuming the water still to be clean and no known under-lying pathology affecting the ear canal and/or middle ear].

Unfortunately, owing to the increasingly litigious society in which we live, it is becoming ever more difficult to find GPs’ practices who are willing to allow syringing. Naturally, this has serious knock-on potential consequences for hearing aid users: poor hearing > get hearing aid > better hearing > produce more wax > poor hearing > no removal > virtually no hearing. Although those fortunate enough [in the UK] to have effective private medical insurance to pay ENT consultants to remove the offending earwax build-up, it could be very costly for others.

So, finally
Earwax is a natural product that we need but don’t want too much of. Please try to keep it under control, especially if you wear hearing aids. And, as Granny said: “Just use your elbow in your ear!”

If you have jumped down to here without reading, you can meet Dr Bill, click on this link http://www.youtube.com/watch?v=3UWq0gZhn_k
and watch and listen instead.
If have already read it, then you’ll have a more in-depth knowledge when you check out the link!

For ENT contacts; Earol; more ear toilet advice; tinnitus advice; hearing aids and protection:

http://www.easi-ear.com

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Easi Ear, Hearing Aids, Hearing Impairment, Hearing Protection, Hearing Tests, Ian Croft, Tinnitus advice & help.

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