UT Southwestern specialist leads effort to craft first professional guidelines for regarding earwax

Dr. Peter Roland, chairman of otolaryngology -- head and neck surgery, helped develop new national guidelines regarding the removal of wax from the ear. Click here for more information.

DALLAS – Aug. 29, 2008 – The age-old advice to routinely clean out earwax is discouraged under the first published guidelines from health care professionals about removing wax from the ear.

"Unfortunately, many people feel the need to manually remove earwax, called cerumen, which serves an important protective function for the ear," said the guidelines' lead author, Dr. Peter Roland, chairman of otolaryngology – head and neck surgery at UT Southwestern Medical Center. "Cotton swabs and some other home remedies can push cerumen further into the canal, potentially foiling the natural removal process and instead cause build-up, known as impaction."

The guidelines recommend professionals use wax-dissolving agents, irrigation or ear syringing, or manually remove it with a suction device or other specialty instrument under supervised care to avoid damaging the ear or further impaction. The guidelines warn against using cotton-tipped swabs, and the home use of oral jet irrigators.

In addition, people with hearing aids should be checked for impaction during regular check-ups because cerumen can cause feedback, reduced sound intensity or damage the hearing aid, according to the guidelines.

The guidelines were created with input from family practitioners, pediatricians, internists, nurses, audiologists and emergency room doctors and have been endorsed by the American Academy of Otolaryngology – Head and Neck Surgery.

There are no proven methods for avoiding impaction, according to the analysis, so when should you seek out a professional?

"When cerumen builds to the point of causing symptoms such as pain, ringing, itching or hearing problems, it's a sign you should see a physician," said Dr. Roland, who also serves as chief of pediatric otology at Children's Medical Center Dallas.

The problem affects one in 10 children, one in 20 adults, and greater than one-third of the elderly and cognitively impaired, according to the academy. About 12 million people annually seek treatment for impacted or excessive cerumen, resulting in nearly 8 million cerumen removal procedures by health care professionals.