WAX IN THE EAR
WHAT IS WAX?WHAT ARE IT'S SYMPTOMS AND TREATMENT OF WAX?
Wax is a normal formation in the external auditory meatus. It is a collection of certain secretions like the secretions from sebaceous and sero-mucinous glands.Initially the secretions are liquid but due to evaporation of moisture , the secretion drys, and forms a semisolid or brownish or black looking substance. This substance forms plugs in external auditory meatus and may give rise to certain symptoms. The normal function of WAX is to protect the tympanic membrane.The protection is achieved by :
a) Preventing excessive or loud sound waves to strike the tympanic membrane directly. The plug of wax acts as a buffer.
b)Preventing the foreign bodies because of it's sticky in nature.
- No symptoms.
- Blockage or deafness in particular part of ear. it is more notified when some water goes in and wax swells up and blocks the meatus . Deafness is sudden and painless.
- Wax may directly attach the tympanic membrane giving rise to a feeling of foreign body in the ear.
- May give rise to vertigo and dizziness.
- Pain but this pain is not because of wax, but because of inflammation of skin of meatus which is due to ulceration and secondary infection. The wax becomes completely adherent to the skin and cause ulceration.
If there is no symptom then leave it alone.
If symptoms are present then the treatment is " TO REMOVE WAX ".
Removal of wax depends upon whether the wax is hard or soft. In case of hard wax it is not advisable to remove it straightway because it will produce pain and ulceration. Therefore first hard wax is made soft by putting various substances and then remove the wax. The softening substances are :
a) Olive oil, 4-5 times a day for 2 days and then remove the wax.
b) Soda glycine drops, (10 gm. of soda bicarbonate + 2 drops of glycerin + 2 drops water) 2-3 drops 6-8 times a day for at least 24 hours or till the wax becomes soft.
REMOVAL OF WAX IS DONE BY :
- Blunt hook.
- Syringing by warm water ( this is the best method) :-
Take a syringe full of warm water , remove the air from it and hold the syringe in right hand. With the left hand pull the pinna and introduce the nozzle of syringe in the meatus. The nozzle should be directed against either the posterior wall or roof, but not in the centre of the meatus because , the force of stream is taken away by the wall of the meatus; if stream is in the centre the wax is pushed inside or stream may strike the tympanic membrane causing perforation .
The water against the wall ,goes inside the meatus, strikes the tympanic membrane gently and come out with the plug of wax or foreign body. Gentle Syringing is done 2-3 times a day till the membrane is clear.
PRECAUTIONS OF SYRINGING:-
- Water should be moderately warm. Cold or Hot water stimulates the vestibular apparatus and patient may feel giddiness.
- Remove all the air from the syringe, otherwise the air along with water causes a peculiar voice which is not liked by the patient.
- Direction of stream should be towards the posterior wall or roof.
- Do not injure the meatus.
- After syringing, dry the meatus by cotton wool otherwise moisture will cause secondary infection.