Directions for use
21
Types of Cerumen
Cerumen is the natural by-product of the ear canal. It lubricates the skin
lining in the ear canal, acts as a water repellent, and entraps dust, hair
follicles, and foreign bodies. Cerumen can take many different forms
which affect the process and time to remove. There are generally two
different types of cerumen found in the ear canal: dry and wet. The
following are subtypes of cerumen that you will commonly encounter and
how they may affect the irrigation procedure.
White/Flaky Cerumen
This form of cerumen will easily dissolve in the irrigation water. The
irrigation procedure is relatively short, and a cerumenolytic agent is not
always necessary. Often you will not see solids trapped in the ear tip with
this form of cerumen; rather, you will see some of the dissolved cerumen
trapped in the ear tip screen. The rest of the dissolved cerumen will leave
through the exit port of the chamber.
Light Brown/”Jelly-Like” Cerumen
This cerumen resembles the consistency of petroleum jelly and does not
completely dissolve in the irrigation water. Some solids may be present in
the ear tip, and the procedure time is slightly longer than for the white/
flaky variety. A cerumenolytic agent is recommended to shorten the time
of irrigation.
Dark/Hard Cerumen
This cerumen is often found lining the walls of the canal and forms a plug
in the patient that can cause significant hearing loss. Large solids of
cerumen are seen trapped in the ear tip and the procedure time is often
longer than the wet/”jelly-like” cerumen. A cerumenolytic agent is often
necessary to shorten the time of irrigation.
Anatomy And Physiology
•
Cerumen is produced in the outer third of the ear canal and
naturally moves to the outer ear as new tissue grows from the
area around the tympanic membrane.
•
Normal cerumen routinely becomes a medical issue when it
impedes the physicians ability to visualize the tympanic
membrane. Less frequently, cerumen can accumulate and
harden, in the canal causing occlusion of the ear canal. In the
