View source for Cerumen removal

==Overview==
*Cerumen impaction is caused by the buildup of wax within the ear canal and can lead to [[hearing loss|decreased hearing]], pressure or fullness, [[dizziness]], [[tinnitus]], or [[otalgia|pain]].

==Indications==
*Pain, hearing loss, vertigo, disequilibrium
*Visualization of symptomatic TM

==Contraindications==
*[[TM rupture]] or myringotomy tubes

==Equipment Needed==
*Warm Water
*5 or 10 cc syringe
*Soft tubing from catheter

==Procedure==
===Three Methods===
*Cerumenolytic agents
**Water based
*** acetic acid, colace, hydrogen peroxide, sodium bicarbonate, sterile saline
**Oil Based
***Almond oil, Peanut oil, Olive oil, Mineral oil
**Debrox
*Irrigation
**5 cc syringe with warm water and soft tubing from catheter
**Jet lavage
**Repeat until wax flushed out
*Manual Removal
**Perform under direct visualization
**Soft, disposable plastic variety preferred to metal cerumen spoon/curettes

==Complications==
*Increased risk of infection in immune compromised patients
*Hemorrhage or hematoma in patients on anticoagulation
*Irrigating with cold or hot solution may lead to vertigo, nausea, vomiting

==See Also==

==External Links==

===Videos===
{{#widget:YouTube|id=o0I9DWl7ARA}}

==References==
<ref> Buttaravoli and Hulsey, Cerumen Impaction, Chapter 26, Minor Emergencies, 3rd edition, 2013</ref>
<references/>

[[Category:Procedures]]
[[Category:ENT]]