ear, nose, and throat disorders
How To Remove Cerumen Manually and With Irrigation
Additional Considerations for Cerumen Removal
Patients who are asymptomatic should not have cerumen removed. Anesthetic drops are not effective in reducing discomfort from cerumen removal, and local anesthetic injection is very painful, so neither is used. Dental jet devices (“water picks”) are used by some, but the stream from these (even on low settings) can rupture the tympanic membrane. Proper lighting is essential for both the initial examination of the canal and the manual cerumen-removal procedure. The irrigation method is preferred for patients who are not able to remain still. Manual removal may be preferred in selected adults because it can be faster and is more effective in removing large, hardened accumulations. However, softening with a cerumenolytic and irrigation are often tried first and may facilitate manual removal. Before and after attempting to remove cerumen, clinicians should consider doing a Evaluation if the necessary equipment is readily available. 