Dr.K.O.Paulose FRCS, Consultant ENT Surgeon, Jubilee Hospital, Trivandrum.

Wax in the ear, medically referred to as Cerumen, is produced by ceruminous glands (sweat glands) in the outer ear canal. It is an oily secretion which repels water and contain many antibacterial and antifungal enzymes. Having honey like ear wax is normal and a sign of healthy ear.
Everyone makes ear wax, although some people make more than others. Normally, the wax come out by itself or the wax dries up and falls out of the ear, along with any trapped dust or debris. There are two types of ear wax-dry wax and wet wax depending upon a particular gene in each individual.
Self cleansing mechanism of the ear- The healthy ear cleans itself. Tiny hairs lining the ear canal remove the wax slowly outwards. You donot need to clean your ears, the ear do its own job.
Some patients have wax dry up and get impacted in deep inthe ear, causing all kinds of problems. This can cause pain, fullness, noise in the ear or hearing loss.
Home remedies for wax removal
Putting warm olive oil or almond oil, sodabicarb ear drops at night for few days soften the ear wax.
Over-the-counter wax softening drops like Otores®, Waxolve® also do the job, but some patients are allergic to the chemical ingredient in the drops.
Dewaxing the Ears
The doctor may remove the earwax with a small hook or a curette, or by irrigating the ear with warmed water or saline.

Don\’t Use Cotton Buds
Earwax blockage can be prevented by avoiding the use of cotton buds and other objects that push the wax deeper into the ear canal.
Individuals with hearing aids should be routinely examined for earwax impaction every 3 to 6 months.
Safe Ear Wax Removal
Ear Syringing
Some doctors use pressurized water or saline to remove deep wax.Ask the patient first whether they had any perforation of the ear drum.

Suction clearance under Microscope
It is better to use a wire loop under a strong headlamp to remove the wax gently. Or, vacuum the ear with light suction. Either way, the doctor should always view the cleaning area with a strong light. It is always safer to do this under an operating microscope.(see pictures).
