Wax impaction

Question 1

Features

Answer 1

Occurs in at least 5% of normal population

Common in nursing homes and institutions

Often follows cotton-bud self-cleaning and hearing aid use

Mostly clears spontaneously

Question 2

Methods of removal

Answer 2

Direct removal with microforceps

Gentle syringing with warm (body temperature) water or saline by a trained practitioner

Consider ceruminolytic drops prior to syringing:

• carbamide peroxide (Ear Clear)
• docusate sodium (Waxsol)
• hydrogen peroxide
• sodium bicarbonate
• oil based—olive oil, almond oil