Wax

• It is a mixture of secretions of the ceruminous and sebaceous glands with desquamated skin cells.

• It is expelled outside the canal, in the form of flakes, by epithelial migration.

• Abnormal accumulation of ear wax (cerumen) in the external auditory canal Hearing loss.

• Functions of wax:

1. Lubrication of the skin of the external canal.

2. Prevent dust and sand to enter the ear as they stick to it.

3. Contains some fungicidal and bactericidal enzymes.

• Incidence:

Wax accumulation is the commonest cause of conductive hearing loss in adults.

• Causes of wax accumulation:

Failure of the natural cleaning mechanism because of:

1. Narrow external canal.

2. Attempt of the patient to clean his ear with cotton buds ≫ pushing the wax deeper into the canal.

3. Increased wax production due to skin irritation by soaps and shampoos.

4. Dehydration ≫ thick and hard wax.

• Clinical picture:

1. Unilateral or bilateral fullness of the ear, hearing loss, tinnitus especially after bathing.

2. A brownish mass in the external canal.

• Treatment:

Removal by ear wash or instruments.

If the wax is hard ≫ softened before wash by a wax solvent as glycerin bicarbonate ear drops.

Category: ENT Notes