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Earwax, also known as cerumen, is a physiological substance that cleans, protects and lubricates the ear canal.

This substance is a natural secretion from the sebaceous and apocrine glands to capture dust and dirt, as well as repelling water from the tympanic membrane.
Put simply, the functions of earwax are to clean and lubricate the ear canal and protect it from bacteria, fungus, and insects.

The high concentration of lipids in the sebum produced by the sebaceous glands lubricates the ear and acts as a water repellent and natural soothing agent.

The external ear canal is self-cleaning, thanks to the movement of the jaw (while you chew, talk, and even yawn) that causes the earwax to move outside.

Despite this self-cleaning mechanism, a lot of people tend to suffer from earwax accumulation and impaction because of excessive production or reduced elimination efficacy.

Impaction does not necessarily mean that the ear canal is completely obstructed.

How frequent is earwax impaction?

Cerumen impaction is present in:

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Approximately 10% of children

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5% of healthy adults

Estimates suggest that between 19% and 65% of patients over 65 years old have cerumen impaction and that this percentage increases for elderly patients in nursing homes.

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Some reports suggest that up to 36% of patients with intellectual disabilities suffer from earwax impaction. The reasons for this increased prevalence are not clear.
However, anatomical differences in the structure of the canal (associated with Down syndrome, for example), poor hygiene or excessive cerumen production may be contributing factors.

Causes of excessive production:

● Irritation due to foreign objects (hearing aids and earplugs).
● Over-cleaning of the ear.
● Chemical irritation: hairspray, gel, shampoo, constant moisture due to lack of drying, etc.

Causes of reduced elimination efficacy:

● Anatomical deformity of the ear canal.
● Increased number of hairs in the ear canal.
● Physical barriers to natural ear wax elimination (e.g. cotton swabs, hearing aids, earplugs, etc.).

While often harmless, blockage of the ear canal by earwax can lead to a host of symptoms.

Namely:

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Hearing loss
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Tinnitus
(ringing sound in the ears)
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Sensation of fullness
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Itching
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Pain
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Discharge
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Odour
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Cough

In addition, earwax impaction can make diagnostic assessment more difficult, as it prevents your doctor or nurse from seeing the external ear canal and/or tympanic membrane correctly.

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