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Ear – to Clean or not to Clean – the Eternal Dilemma

Almost everyday in my clinical practice, someone will pop up this question – “Doctor, how to clean the ear?” for which the answer is quite simple, ear is self-cleansing and it doesn’t need regular clean-up . Cerumen which is called as wax is secreted normally in ear, function of which is to protect our ear from infections by trapping foreign body and by producing certain enzymes which has anti-bacterial property. It is normally brownish or yellowish in colour, it can vary from person to person in colour and texture. It is constantly being secreted by the skin of ear canal and pushed out simultaneously combined with the migration of skin debris from inward to outward direction It creates problems when our ear canal is not able to push it out normally due to some injury, infection or alteration in the framework of ear canal. Injury not needed to be major, a small ear bud can cause micro injuries and worse it can damage the epithelia migratory pattern and thus accumulation cerumen. When the migration is affected, ear canal traps the wax inside, at a later stage completely occluding canal causing severe pain and temporary hearing loss [because it impedes the conduction of sound]. When such condition occurs it’s advisable to consult a doctor. Usually they will prescribe some wax solvents and then remove it under vision. It’s not advisable to try to remove it by oneself because it will further push the wax inside also there are chances of inadvertently injuring ear canal and ear drum Methods for removal of cerumen: Usually removal is not attempted if the wax is too hard because while removing it can cause mild discomfort or pain in the ear canal which is not desirable. The physician/surgeon prescribes ear drops to soften the wax and its removed by any of these following methods

1. Syringing: water or saline is irrigated with the help of a syringe which will wash out all the accumulated cerumen. It cannot be done in the persons having a perforated ear drum.

2. Suctioning: here controlled negative pressure will be created in a hand held device which will suck out the accumulated debris , this can be safely done in patients having perforated ear drum

3. Removal with a probe: here a micro instrument in the shape of a scoop is used to remove cerumen. This is commonly used when the wax is hard Syringing and suctioning are the common modalities used for removal of cerumen. Key points: 1 .Ear is self-cleansing and it doesn’t needs cleaning on regular basis 2. Using ear probes could lead to infection in ear canal, also can cause injuries in ear canal or ear drum 3. In case of impacted cerumen, it has to be removed by a doctor, using ear buds will push the wax further deep inside the ear canal.


Consultant Pediatric ENT, Marathahalli, Bengaluru MBBS, ENT