ear wax

Question 1

what are the common symptoms of ear waz?

Answer 1

o Conductive hearing loss.
o Blocked ears or a feeling of fullness in the ear o Earache
o Tinnitus
o Itchiness
o Vertigo

Question 2

what are the red flags symptoms of ear wax?

Answer 2

• Refer before irrigation (earwax removal) if:
o The person has (or is suspected to have) a chronic perforation of the tympanic
membrane
o There is a past history of ear surgery
o There is a foreign body in the ear canal
o There is a visible tympanic membrane perforation
• Seek immediate advice from an Ear Nose and Throat (ENT) specialist if severe pain, deafness, or vertigo occur during or after irrigation
• Refer or seek urgent advice if infection is present and the external canal needs to be cleared of wax, debris, and discharge
• If the person continues to experience hearing loss after wax removal

Question 3

what is the lifestyle advice for ear wax?

Answer 3

• Advise people against inserting anything in the ear. Cotton buds, matchsticks, and hair pins can:
o Damage the wall of the canal and increase the likelihood of otitis externa o Cause the wax to become impacted by pushing it further into the canal
o Perforate the tympanic membrane
• Advise that the use of ear candles has no benefit in the management of earwax removal and may result in serious injury

Question 4

what are some drug treatment options for ear wax?

Answer 4

Olive oil, or almond oil drops can be used 3-4 times daily for 3-5 days (consider
allergies)
o Sodium bicarbonate 5% ear drops

Question 5

what do you need to warn patients when using ear wax?

Answer 5

• Warn the person that instilling ear drops may cause transient hearing loss, discomfort, dizziness and irritation of the skin.
• If symptoms persist, try an alternate product or refer the patient on for ear irrigation
• Advise anyone who has had earwax removed to return if they develop otalgia, or significant itching of the ear, discharge from the ear (otorrhoea), or swelling of the external auditory
meatus, as this may indicate infection

Question 6

what is Otitis externa?

Answer 6

condition that causes inflammation (redness and swelling) of the external ear canal, which is the tube between the outer ear and eardrum

Question 7

how would you treat otitis externa/

Answer 7

• This may be treated with acetic acid 2% (EarCalm®), available as a P medicine
• A referral to the doctor should be made if you suspect the infection has spreader deeper
into the ear, or treatment failure with acetic acid 2% after two days of use