Wax to be removed or not

Wax often gets blocked due to curved or tortous External auditory canal & due to Q tip usage.When its hard blocking sound transmission impeding hearing we need to intervene to remove wax.

Cerumen (earwax) prevents the loss of water from the skin (desiccation) and so maintains the skin’s normal health balance and appearance. This is largely due to the oil content of cerumen and its fatty acids.

Cerumen also has a bactericidal effect on some strains of bacteria. It is “bacteriostatic” as it may prevent some bacteria reaching deeper into the bony portion of the ear canal. Cerumen has been found to reduce the viability of a wide range of bacteria, including influenza and staphylococcus aureus. The growth of fungi commonly present in otomycosis is also significantly inhibited by human cerumen, however, cerumen is not an effective bactericidal against all pathogens.

As well as providing moisture and acidity, the sticky texture of earwax also acts as barrier to foreign bodies entering the ear canal. Examples could be debris such as sand or even an insect.

Migration process; the ear’s self-cleaning mechanism

You may be surprised to learn that the skin from your eardrum (tympanic membrane) to the outer part of your ear canal, is created from the centre of your eardrum called the Umbo.

New skin cells form at the Umbo and move outwards to the edge of the eardrum before moving outward in the canal, towards the entrance. The skin is smooth in the inner most two thirds of the ear canal as it moves over bone. When the skin reaches the outer third of the meatus, it enters the fleshy (cartilaginous) portion. This contains the cells that produce cerumen (earwax) as well as hair follicles. The skin wrinkles and eventually breaks, forming dead skin cells that flake off or mix with the cerumen depending on the dry or wet type of earwax produced.

The process of skin cells migrating out of the ear canal is sometimes called the “conveyor”. If a black dot were placed just off centre of the eardrum, it would take months for it to reach the outermost part of the ear canal. The movement (migration) of skin out of the ear canal is not fully understood and the speed of migration is not affected by jaw movement, as previously thought.

ear wax removal with microsuction is widely accepted as the safest, most effective method of resolving ear blockages and is superior to other water-based methods such as syringing. It is performed using a small suction machine which draws wax out of the ear and into a sealed cannister. A thin tube attached to the machine is comfortably placed inside the ear canal, only making contact with the wax and never the patient's ear canal or ear drum. The ENT Surgeon will use a special camera called an Endoscope so they are able to see inside the ear canal and exactly what needs to be removed.