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Systematic review
Limited good-quality evidence available on earwax removal methods; softeners more effective than no treatment, but evidence for irrigation or mechanical removal is equivocal
  1. Yehudah Roth1,
  2. Yahav Oron1,
  3. Abraham Goldfarb1
  1. 1Department of Otolaryngology – Head and Neck Surgery, The Edith Wolfson Medical Center, Holon, Israel
  1. Correspondence to: Yehudah Roth
    Department of Otolaryngology – Head and Neck Surgery, The Edith Wolfson Medical Center, PO Box 5, 58100 Holon, Israel; orl{at}

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Cerumen impaction is common and saliently affects well-being

Cerumen excreted from the skin of the external ear canal provides a protective oily layer, entraps foreign materials and has antibacterial properties. It is produced by special glands and usually is degraded in parallel, so in most people there is no wax accumulation. If a large quantity of wax is retained, it blocks the ear canal and severely interferes with hearing. Such blockage can easily be removed to resume previous hearing.

Impaction is caused by ear ‘cleaning’ with Q-tips which often creates a piston mechanism that pushes the wax inside the canal towards the tympanic membrane. This is one of the reasons why regular wax removal or ‘cleaning’ is not recommended. Some populations though tend to develop frequent cerumen impaction, which is reflected as reversible, profound, hearing loss. Other symptoms include tinnitus, itching, cough, dizziness or pain. Reasons for higher prevalence include drier secretions, metabolic changes and genetics.

Some 5% of the general population in the …

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