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The Wonders of "Tutuli" (Cerumen)


Cleaning our ears feels kind of nice. Right? Like scratching an itch. Getting out that nasty looking orange/brown/yellow wax gives one a sense of accomplishment. We look at the stain on the cotton buds with a certain element of personal pride. But, some of us, despite doing it almost everyday, end up having a condition called 'impacted cerumen'.

Here's a post regarding it.

Cerumen impaction is a condition in which earwax has become tightly packed in the external ear canal to the point that the canal is blocked. It develops when earwax accumulates in the inner part of the ear canal and blocks the eardrum.

Impaction does not happen under normal circumstances because cerumen is produced by glands in the outer one third of the ear canal; it is not produced in the inner part. The cerumen traps sand or dust particles before they reach the ear drum. It also protects the outer part of the ear canal because it repels water. The slow movement of the outer layer of skin of the ear canal carries cerumen toward the outer opening of the ear. As the older cerumen reaches the opening of the ear, it dries out and falls away.

So, cerumen is most likely to become impacted when it is pushed against the eardrum by cotton-tipped applicators, hair pins, or other objects that we put in our ears. Less common causes of cerumen impaction include overproduction of earwax by the glands in the ear canal which happens to some of us, or an abnormally shaped ear canal.

The most important symptom of cerumen impaction is partial loss of hearing. Other symptoms are itching, tinnitus (noise or ringing in the ears), a sensation of fullness in the ear, and pain.

Irrigation is the most common method of removing impacted cerumen. It involves washing out the ear canal with water from a commercial irrigator or a syringe with a catheter attached. Although some doctors use Water Piks to remove cerumen, most do not recommend them because the stream of water is too forceful and may damage the eardrum. The doctor may add a small amount of alcohol, hydrogen peroxide, or other antiseptic. The water must be close to body temperature; if it is too cold or too warm, the patient may feel dizzy or nauseated. After the ear has been irrigated, the doctor may instill antibiotic ear drops to protect the ear from infection.

Irrigation is not to be used to remove cerumen if the one's eardrum is ruptured or missing; if the one has a history of chronic otitis media (inflammation of the middle ear) or a myringotomy (cutting the eardrum to allow fluid to escape from the middle ear); or if one has hearing in only one ear.

If irrigation cannot be used or fails to remove the cerumen, your ENT specialist can remove the wax with a vacuum device or a curette, which is a small scoop-shaped surgical instrument.

Some doctors prescribe special ear drops, such as Otosol, to soften the wax. A 3% solution of hydrogen peroxide or mineral oil may also be used. These products are less likely to irritate the skin of the ear.

The big difference between taking some nasal crusts ("boogers") and removing earwax is that one is important and the other is not. Both have a bad reputation.

We wax our tables and we wax our cars in order to protect the surface. That is exactly one of the functions of earwax (cerumen). A waxy surface repels water -- it will bead up and the water will not adhere. Another protective function of earwax is preventing infection. Earwax is acidic, and bacteria does not thrive in an acid environment. If you take out the wax, you change the acidity of the ear canal lining and you are asking for an infection. If you take out earwax every few days, or even after every shower, your body will just make more and more. Why? Because it is supposed to be there. You should no more remove all of the saliva from your mouth, or the tears from your eyes, than remove the wax from your ears.

Ears are self-cleaning (just like the eyes or nose). By gravity and body heat, the wax will gradually make it to the opening where you can wipe if off with a washcloth or rinse it away in the shower. That is all you really need to do with earwax.
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