Cerumenocklusion

Cerumenocklusion is a condition in which cerumen, or earwax, accumulates and forms a plug within the external auditory canal, potentially obstructing the passage to the eardrum. It ranges from mild buildup to complete occlusion and can affect one or both ears.

Symptoms commonly include reduced hearing on the affected side, a sense of fullness or pressure in the ear, mild earache, tinnitus, and sometimes dizziness. On examination, a clinician may observe wax partially or fully blocking the canal; the eardrum may be difficult to visualize.

Causes and risk factors include natural variation in wax production, a narrow or curved ear canal, and practices that push wax deeper into the canal such as aggressive cleaning with cotton swabs or earbuds. Aging, dermatitis of the ear canal, and the use of hearing aids or earplugs can also contribute to impaction or recurrent buildup.

Diagnosis is typically clinical, based on history and otoscopic examination. Additional testing, such as audiometry, may be used if there is suspected hearing loss, to assess the extent of conductive impairment.

Treatment involves safe removal of the blockage by a healthcare professional, using methods like cerumen suction, gentle instrumentation, or irrigation when appropriate. Pre-removal wax-softening drops (for example, carbamide peroxide) may be used to facilitate extraction. Self-removal attempts with objects should be avoided to reduce risk of injury.

Prognosis is generally favorable after removal, though recurrence is common. Prevention focuses on avoiding insertion of objects into the ear canal and seeking professional evaluation for persistent symptoms or repeated wax buildup.