ear, nose, and throat disorders
External Ear Obstructions
Cerumen
Cerumen may be pushed farther into the ear canal and accumulate during patients' attempts to clean the ear canal with cotton swabs, resulting in obstruction or impaction. Cerumen solvents (hydrogen peroxide,carbamide peroxide,glycerin, triethanolamine, liquiddocusatesodium, ormineral oil) may be used to soften very hard wax before direct removal. However, the prolonged use of these agents may lead to canal skin irritation or allergic reactions. In general, cerumen impaction that is severe enough to prevent visualization of the eardrum should be managed by an otolaryngologist, when practical. sodium. Irrigation is contraindicated in patients with a known tympanic membrane perforation or with a suspected infection. Water entering the middle ear through a tympanic membrane perforation may exacerbate Otitis Media (Chronic Suppurative) and cause an (See alsoAmerican Academy of Head and Neck Surgery Practice Guidelineson management of cerumen.) 