Your Audiology Tutorial: Ear Candling

Cerumen, or ear wax, gets a bad rap. Patients prod their ears with cotton swabs, pencils, paper clips (I've also been told, to my horror, knives) in efforts to retrieve and discard the stuff. Truth is, cerumen is not necesarily bad, as it has antibiotic properties and is handy for keeping insects out of there! Some patients, however, seem to have miniature wax factories that are so productive that the canals are entirely occluded even a few months later for follow-up visits. Why? Genetics could be a factor. Ironically, those Q-Tips that feel so good and seem to be effective at cerumen removal also (when shoved beyond the outer cartilaginous structure known as the pinna, or auricle), stimulate more wax production. The sweat and sebacous glands underneath the thin skin layer (quite sensitive) of the canal respond to the swab or other object's scraping back and forth by creating more of the pesky substance. Patients who wear custom made hearing aids also quite ironically find that their ears make more and more wax over time due to the stimulation the device causes by constantly being fit into the ear.

What to use to eradicate? Commercially prepared peroxide based products can help. A few drops can break up the surface tension of the wax and after the head is properly tilted, the remants can seep out. A rubber bulb syringe filled with (ONLY!) lukewarm water can help facilitate things. Also, stool softening liquids can also break up the wax. If the wax problem is severe/impacted, the audiologist and/or ear, nose, and throat doc can use a variety of methods: alligator forceps, currets, water irrigation, or suction. There is also an alternative known as "ear candling."

Ear candling is a procedure that attempts to extract the wax from a patient's ear canal by way of a burning wick. It is performed by a variety of personnel, not all of whom have any sort of licensure. Audiologists do not typically perform ear candling for a multitude of reasons. The link provided gives a solid overview of why this method is ineffective at best and sometimes even dangerous. Two of my classmmates in grad school attempted a round of ear candling; their results are presented at the conclusion of the article (complete with images of an ear canal pre- and post procedure).

http://www.audiologyonline.com/articles/pf_article_detail.asp?article_id=1501