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| Impacted Cerumen |
The most common foreign body in our bodies is this condition. Although it is not an emergency, it still warrants immediate removal. Failure to do so leads to its accumulation and hardening which may cause difficulty in hearing. This is very common in school-age children. Busy mothers fail to inspect their children’s ears. Sometimes it’s only an accidental finding during regular physical examinations done in schools. At times, it is the teacher complaining that the child is not listening inside the classroom or is having poor performance in school.
Cerumen is produced by glands located in the external ear canal. It has the advantage of repelling water and trapping dust particles. It becomes impacted due to use of objects put inside the ears which pushes the cerumen towards the inner part of the ear. It then accumulates inside and blocks the eardrum. Another cause may be is overproduction of ear wax.
The removal of the cerumen is done by instilling oil inside the ear canal every night for at least two weeks. This is done to soften the cerumen making removal easier and less painful. After two weeks the child can be brought to a physician who can perform the mechanical removal of the cerumen.
An otoscope with an operating head is usually used. The child must be advised to refrain from moving or must be restrained. Insert slowly a wire loop or wax curette inside the ear canal then slowly scrape the cerumen taking care not to curette the ear canal. This procedure is usually done by an ENT specialist.
Another method is by irrigating the ear canal with water in normal body temperature using a syringe. The jet of water should be aimed along the canal and behind the cerumen in order to push it out. This procedure is usually avoided in children with perforation or with tympanostomy tube.
There are cerumenolytic agents available in the market which can be used to remove cerumen but these sometimes cause severe local reactions especially if not properly used. The best prevention in order not to have impacted cerumen is regular cleaning of the external ear with a washcloth. There is no need to go inside the ear canal using cotton buds, hair pins and the like. The wax that is present inside the ear canal will fall off on its own. |
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