Never put anything smaller than your elbow in your ear! Do not use cotton swabs to clean your ears! You have probably heard such warnings from relatives and doctors. But why?

The outer ear consists of the cartilaginous structure seen on the sides of the head and the ear canal, which is the passage leading down to the eardrum. The skin of the outer part of the canal has special glands, called ‘cerumen glands’ which produce ear wax (cerumen). It isn’t really wax as in the ‘candle wax’ sense but a sticky liquid whose purpose is to trap dust and dirt particles and keep them from reaching the eardrum. Usually the wax builds up, dries out and comes tumbling off the ear, carrying dirt and dust with it. Movements of the jaw can also move it to the outside of the ear canal, where it can be wiped off.

Ear wax is healthy in normal amounts and serves to coat the skin of the ear canal where it acts as a temporary water repellent. The absence of ear wax may result in dry, itchy ears. Most people’s ears clear the wax, which probably comes off on the pillow and towels. Some people may at some stages in their lives produce wax at a faster rate. Most have either one or both ear canals that are narrow or is at an angle which slows the natural passage of the wax. In such people wax tends to build up. You may notice a build up of wax by:

• Having increasing difficulty in hearing

• Pain in your ear/s

• Ringing of the ears (tinnitus)

• A feeling of something blocking your ears

• Temporary deafness after swimming

However, many times the ear canal can be blocked when attempts to clean the ear results in wax being pushed deeper inside the ear. Some people may use cotton buds while others experiment with twisted napkin corners and even hairpins and matches. These objects only push the wax in deeper, and could prove very dangerous as it may result in ear drum perforation.

A variety of treatments are available to loosen and dissolve wax in the ear. Fixed oils, such as olive oil and almond oil, have been found to be effective and safe to soften ear wax. More specific products include the ‘cerumenolytics’. These preparations are usually oily solvents and are found in the form of drops to be instilled in the ear. Cerumenolytics are often prescribed by doctors for ear wax softening prior to syringing. These products should not be used for long periods and only used after consulting a pharmacist or doctor, as patients often mistake and associate any ear problem, including hearing loss, pain and discomfort to this cause. Fixed oils and cerumenolyitics soften wax and make it easier to remove with syringing, but they are ineffective in dissolving and removing compacted plugs of wax on their own.

Innovative treatments are available on the market. These products consist of pressurised saline water which is sprayed into the ear. The saline water will settle along the ear canal, degrading any ear wax that might be occluding the canal and impairing hearing. If used daily, these products prevent the formation of ear wax plugs and serve as a daily solution for ear cleansing. Using these innovative sprays, one would eliminate any chance of ear wax impaction and ear drum perforation.

Mauro Abdilla

B. Pharm (Hons)

www.cherubino.com.mt