- Cerumen (ear wax) is an oily fluid produced in the ear. It combines with
exfoliated skin cells to form a protective waxy layer. In some people excessively
sticky cerumen is produced that cannot be removed by the normal natural
processes, and a waxy plug forms that causes discomfort and can affect hearing.
- Pharmacists should not attempt to diagnose ear wax. Patients often incorrectly
ascribe their ear symptoms to it, but the presence of wax can only be confirmed
by examination with an auriscope. Pharmacists can, however, offer advice on
cerumenolytics once the condition has been diagnosed by a doctor or suitably
qualified nurse.
Syringing is usually necessary to remove ear wax, although cerumenolytics can
be used in advance to soften, loosen and partially dissolve it.
Treatment
Several approaches are taken to loosening and dissolving wax in the ear,
including the use of aqueous and oily solvents and surfactants, and oxygen
generation to facilitate penetration of water into the plug. Constituents of
cerumenolytic products include:
– fixed and volatile oils, as wax solvents
– glycerol, as a softener
– docusate, a surfactant facilitating the penetration of water
– urea hydrogen peroxide; this reacts with naturally produced catalase enzyme
to release oxygen and help break up wax mechanically, while urea increases
penetration
– paradichlorobenzene, claimed to assist penetration of oils into wax plugs.
Little difference in efficacy has been found between cerumenolytics, and it has
been reported that they are no more effective than using warm water or saline
shortly before syringing.
The British National Formulary recommends olive oil, almond oil or sodium
bicarbonate ear drops for softening wax before syringing.
No comments:
Post a Comment