Ear Wax

Ear wax is also known as cerumen. Wax is an essential, normal and necessary body secretion found only in the ear. Ear wax is found in no other part of the body other than the external ear canal.

The functions of wax are the following:-

  • It water proofs the ear. The external ear canal has a normal film of wax and this prevents most liquids from remaining in the ear. Since the external ear canal is tilted at an angle any fluids entering the ear will slide out. The external ear canal is tilted at an angle below the horizontal thus allowing it to drain by gravity.
  • The ear wax acts as a mild antimicrobial agent. The ear wax prevents germs and fungi from colonizing the external ear canal. Were it not for the ear wax in our external ears harmful germs and fungi would use our ears to enter our bodies causing serious life threatening illnesses.
  • Ear wax also traps debris and then in a conveyor belt like action evacuates all the debris from the ear.
The external ear canal is the only cul de sac lined by skin in the entire human body. In the adult it is approximately 3.75 cms long. It is divided into two parts. The outer cartilaginous part and the inner bony part. The junction between the two is the most vulnerable. Any injury in this area allows infection to invade the ear and skull base and especially in immunocompromised patients.

Should ear wax be removed?

Ear wax in most people does not need to be removed on a daily basis because of a conveyor belt like mechanism that exists in the external ear canal. In other words the ear cleans itself by this self cleaning conveyor belt mechanism that is present in the external ear. The wax is gradually expelled. Movements of the jaw also help in evacuation of the ear wax. Only when the wax gets stuck (impacted) does it need to be removed.

Who should remove ear wax?

Only a trained doctor with adequate instrumentation removed ear wax.
There should be adequate illumination (light) for the ENT doctor to remove the wax and all the proper instruments.
It can be removed with a Vectis or Irrigated with water with a special ear syringe. Sometimes the ENT doctor may need to use a microscope to help remove the wax.

Why should you never instrument your own ear?

  • You cannot see where your ear drum is. Therefore when you insert an object in your ear you may accidentally injure your own ear drum and may even cause it to get perforated.
  • You may injure the skin that lines your external ear canal. The skin that lines your external ear canal is very delicate and thin. If this is traumatized it can bleed. It can get infected and can cause a severe painful infection. In elderly people, in diabetics and in immunocompromised persons this can lead to a severe life threatening illness known as skull base osteomyelitis.
  • When you insert objects in your own ear you may push back all the debris which was about to be expelled from your ear. This may fall back on to your ear drum causing you to feel that your ear is blocked and thus your hearing will get affected.
  • The cotton can fall off the applicator, or the match stick can break off and remain inside your ear canal thus acting as a source of infection. Therefore you should not instrument your own ear.
  • It is possible to contract infections like tetanus, skull base osteomyelitis, fungal infections and other serious life threatening infections because of self instrumentation of your ears.
In summary ear wax is found in healthy ears. When ear wax is not present it makes the external ear canal vulnerable to infections.
Never instrument your own ears with any object. Do not clean your own ears and do not attempt to clean the ears of others. Only a trained doctor with good equipment should clean ears.
All cotton tips come in boxes with warnings against inserting it in the ear canal.
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