Our analyses of InternistWeekly email readership have revealed that our subscribers are particularly interested in any news involving guidelines. Thus, we are embarrassed to report that the Labor Day holiday caused us to miss a new set of guidelines on that most glamorous of topics...ear wax.
Under the headline "Leave that Ear Wax Alone," the Washington Post reports that the American Academy of Otolaryngology--Head and Neck Surgery Foundation has issued the following not-so-surprising advice:
Ear wax is good. ("Cerumen is a beneficial, self-cleaning agent, with protective, lubricating (emollient), and antibacterial properties.")
Q-tips are bad. ("Inappropriate or harmful interventions are cotton-tipped swabs, oral jet irrigators, and ear candling.")
as well as some more specific, clinical recommendations:
Appropriate options for cerumen impaction are (1) cerumenolytic (wax-dissolving) agents, which include water, saline, and other agents of comparable efficacy, (2) irrigation or ear syringing, which is most effective when a cerumenolytic is instilled 15-30 minutes prior, and (3) manual removal with special instruments or a suction device, which is preferred for patients with narrow ear canals, eardrum perforation or tube, or immune deficiency.
Individuals at high risk (e.g., hearing aid users) should consider seeing a clinician every 6-12 months for routine cleaning.