Cerumen impaction: Difference between revisions

(Created page with "==Overview== ==Indications== *Pain, hearing loss, vertigo, disequilibrium *Visualization of symptomatic TM ==Contraindications== *TM rupture or myringotomy tubes ==Equipmen...")
 
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==Overview==
==Overview==
Cerumen impaction is caused by the buildup of wax within the ear canal and can lead to decreased hearing, pressure or fullness, dizziness, tinnitus, or pain.


==Indications==
==Indications==
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==Contraindications==
==Contraindications==
*TM rupture or myringotomy tubes
*TM rupture or myringotomy tubes
[[Tympanic membrane rupture]]


==Equipment Needed==
==Equipment Needed==

Revision as of 12:18, 27 June 2019

Overview

Cerumen impaction is caused by the buildup of wax within the ear canal and can lead to decreased hearing, pressure or fullness, dizziness, tinnitus, or pain.

Indications

  • Pain, hearing loss, vertigo, disequilibrium
  • Visualization of symptomatic TM

Contraindications

  • TM rupture or myringotomy tubes

Tympanic membrane rupture

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 anticouagulation
  • Irrigating with cold or hot solution may lead to vertigo, nausea, vomiting

See Also

External Links

References

[1]

  1. Buttaravoli and Hulsey, Cerumen Impaction, Chapter 26, Minor Emergencies, 3rd edition, 2013