The Procedure: Accumulating earwax and resulting cerumen impaction can present clinically important problems, including hearing loss and altered ear temperature measurements. Yet the condition is very simple to diagnose, and impaction removal is safe, but not without risk. Ear lavage is the easiest and most common way to remove cerumen impactions. The Welch Allyn system’s disposable ear tip seals the ear canal; increased pressure flushes cerumen out, an outflow channel suctions discharge away, and a transparent filter facilitates visualization of visualize cerumen collection. Fluids should always be at body temperature. Otologic syringes (20 to 50 mL) are equipped with an Angiocath or Jelco catheter rather than a needle. Dental irrigation devices can be used in the elderly; the pulsating stream of water can break up the cerumen plug, facilitating removal.
The final step in removing cerumen impaction is patient education. Important points in-clude the following:
• Do not use foreign objects in the ear, including cotton-tipped applicators, bobby pins, or paper clips.
• Ears should be cleaned using a washcloth wrapped around a finger.
• Cerumenolytic agents may be used, but the softened cerumen still must be re-moved physically.
• A health care professional should be contacted in the event of ringing, crackling sounds, or decrease in hearing.