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Earwax (cerumen) may block the ear canal. Even large amounts of earwax often cause no symptoms. Symptoms can range from itching to a loss of hearing. A doctor may remove the earwax by gently flushing out the ear canal with warm water (irrigation). However, if a person has had a perforated eardrum, irrigation is not used because water can enter the middle ear and may cause a middle ear infection. Similarly, irrigation is not used if there is any discharge from the ear, because the discharge may be coming from a perforated eardrum. In these situations, a doctor may remove earwax with an earwax curette, an instrument with a loop at the end, or a vacuum device.
Certain solvents help soften earwax, but they usually must be followed by irrigation, because the solvent rarely dissolves all of the earwax. People should not attempt removal at home with cotton swabs, bobby pins, pencils, or any other implements. Such attempts usually just pack the earwax in more and can damage the eardrum. Soap and water on a washcloth provide adequate external ear hygiene.
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Irrigating the Ear Canal
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The tip of a water-filled syringe is placed just inside the ear canal, and a stream of warm water is gently directed into the canal to remove earwax. This procedure should be performed by a doctor or a nurse.
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Other blockages can occur when people, particularly children, put foreign objects, such as beads, erasers, and beans, into the ear canal. Usually, a doctor removes such objects with a blunt hook or small vacuum device. Sometimes metal and glass beads can be flushed out by irrigation, but water causes some objects, such as beans, to swell, complicating removal. Objects that are deep in the canal are more difficult to remove because of the risk of injury to the eardrum. A general anesthetic is used when a child does not cooperate or when removal is particularly difficult.
Insects, particularly cockroaches, may also block the ear canal. To kill the insect, a doctor fills the canal with mineral oil or thickened lidocaine , a numbing agent. This measure also provides immediate pain relief and enables the doctor to remove the insect.
Last full review/revision July 2008 by Eiji Yanagisawa, MD
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