Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 8-03: Diseases of the Ear Canal + Key Features Download Section PDF Listen +++ ++ Cerumen is a protective secretion produced by the outer portion of the ear canal In most individuals, the ear canal is self-cleansing Recommended hygiene consists of cleaning the external opening with a washcloth over the index finger without entering the canal itself In most cases, cerumen impaction is self-induced through ill-advised attempts at cleaning the ear + Clinical Findings Download Section PDF Listen +++ ++ Fullness in ear Conductive hearing loss when accumulation blocks the canal + Diagnosis Download Section PDF Listen +++ ++ Made by otoscopic inspection + Treatment Download Section PDF Listen +++ ++ May be relieved with detergent ear drops (eg, 3% hydrogen peroxide; 6.5% carbamide peroxide), mechanical removal, suction, or irrigation Irrigation Should be performed with water at body temperature to avoid a vestibular caloric response Should be performed only when the tympanic membrane is known to be intact The stream should be directed at the posterior ear canal wall adjacent to the cerumen plug Use of jet irrigators (designed for cleaning teeth [eg, WaterPik]) should be avoided because they may result in tympanic membrane perforations After irrigation, the ear canal should be thoroughly dried (eg, by instilling isopropyl alcohol or using a hair blow-dryer on low-power setting) to reduce the likelihood of inducing external otitis Specialty referral for cleaning under microscopic guidance is indicated when the Impaction is recurrent Impaction has not responded to routine measures Patient has a history of chronic otitis media or tympanic membrane perforation