Article Sections

Introduction

Cerumen impaction occurs when ear wax accumulates in the external auditory canal (EAC).  It can be asymptomatic or lead to symptoms such as hearing loss and ear fullness.  This article focuses on the management of cerumen impaction.

Pathophysiology

Cerumen is a waxy substance that protects the EAC from microbes and trauma.  It is produced in the lateral third of the EAC (cartilaginous EAC) and is composed of ceruminous apocrine gland secretions, sebum secreted by sebaceous glands, and sloughed epithelial cells of the EAC.

Normally, cerumen is eliminated by the migration of epithelial cells from the medial to the lateral region of the ear canal, as well as by soft tissue movement resulting from motion around the temporomandibular joint.  Impaction results if the natural elimination of cerumen is impaired (eg, narrowing or obstruction of the canal, excess production of cerumen).

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