Earwax - the protection from bacteria, fungus and insects

Earwax, also known by the medical term cerumen, is a yellowish, waxy substance secreted in the ear canal of humans and many other mammals. It plays a vital role in the human ear canal, assisting in cleaning and lubrication, and also provides a degree of protection from bacteria, fungus, and insects. A comprehensive review of the physiology and pathophysiology of cerumen can be found in Roeser and Ballachanda (1997). Excess or impacted cerumen can press against the eardrum and/or occlude the external auditory canal and impair hearing.

Function

Cleaning: Cleaning of the ear canal occurs as a result of the "conveyor belt" process of epithelial migration, aided by jaw movement (Alberti, 1964). Cells formed in the centre of the tympanic membrane migrate outwards from the umbo (at a rate equivalent to that of fingernail growth) to the walls of the ear canal, and accelerate towards the entrance of the ear canal. The cerumen in the canal is also carried outwards, taking with it any dirt, dust, and particulate matter that may have gathered in the canal. Jaw movement assists this process by dislodging debris attached to the walls of the ear canal, increasing the likelihood of its extrusion.

Lubrication: Lubrication prevents desiccation and itching of the skin within the ear canal (known as asteatosis). The lubricative properties arise from the high lipid content of the sebum produced by the sebaceous glands. In wet-type cerumen at least, these lipids include cholesterol, squalene, and many long-chain fatty acids and alcohols (Harvey, 1989; Bortz et al., 1990).

Antibacterial and antifungal roles: While studies conducted up until the 1960s found little evidence supporting an antibacterial role for cerumen (e.g. Perry & Nicholas, 1956), more recent studies have found that cerumen provides some bactericidal protection against some strains of bacteria. Chai and Chai (1980), and Stone and Fulgham (1984), found cerumen to be effective in reducing the viability of a wide range of bacteria (sometimes by up to 99%), including Haemophilus influenzae, Staphylococcus aureus, and many variants of Escherischia coli. The growth of two fungi commonly present in otomycosis was also significantly inhibited by human cerumen (Megarry et al., 1988). These antimicrobial properties are due principally to the presence of saturated fatty acids, lysozyme and, especially, to the relatively low pH of cerumen (typically around 6.1 in normal individuals; Roland & Marple, 1997).

Removal

Excessive cerumen may impede the passage of sound in the ear canal, causing conductive hearing loss. It is also estimated to be the cause of 60 - 80% of hearing aid repairs (Oliveira, 1997). As mentioned above, movement of the jaw helps the ears' natural cleaning process, so chewing gum and talking can both help. If this is insufficient, the most common method of cerumen removal by general practitioners is syringing. A curette method is more likely to be used by otologists and ENTs when the ear canal is partially occluded and the material is not adhering to the skin of the ear canal. It is usually necessary to soften wax before its removal, a process referred to as cerumenolysis. Ear wax may be softened by introducing oil into the ear canal. While medicinal grade oil is preferred, any oil (cooking, baby oil, etc) may be used.

Earwax can also be removed by irrigating the ear with body temperature water. Never irrigate the ear if the eardrum is not known to be intact, because irrigation with a ruptured eardrum may cause ear infection or acoustic trauma. Never irrigate if the ears have burning, bleeding, pus discharge, or pain, without calling a doctor first. Never irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik) because the force of the irrigation may damage the eardrum. A syringe should be used to gently stream water into the ear. For children the rate and speed should be lower. After irrigating, tip the head to allow the water to drain. Irrigation may need to be repeated several times. If the water stream hurts then the flow should be slower. It is better to irrigate too gently for a long period than irrigate too forcefully attempting to remove wax quickly. This procedure can be done at home in the shower using a self-use ear irrigation syringe with a right angle tip. After the wax is removed, the ear can be dried tipping the head then gently pulling the ear upwards to straighten the ear canal. If this does not remove enough water, the ear can be dried with a hair dryer set on low.

While the removal of cerumen is a commonplace procedure, it is not without risk. Irrigation can be performed at home with proper equipment as long as the person is careful not to irrigate too hard. All other methods should be carried out by individuals who have been sufficiently educated and trained in the procedure.

It is generally advised not to use cotton swabs (Q-Tips or cotton buds) as these will likely push the wax further down the ear canal and, if used carelessly, perforate the eardrum or worse. Cotton swabs should be used only to clean the external ear.

A Japanese mimikaki, or ear pickIn Japan, a mimikaki (???), sometimes translated as "ear pick", is a type of curette made traditionally from bamboo used to clean the ear canal. The person having his ears cleaned would lie down with his head in the lap of the person doing the cleaning. It is generally considered a pleasant feeling for Japanese, like having one's back scratched. The cleaning of ears is thus considered an act of intimacy, often performed by a mother to a child, or among adults, by one's lover. It may also be performed alone.

Ear candling, a folk medicine practice, is also used to remove ear wax and improve ear health. It involves placing a hollow candle in the ear canal and lighting it; the rising hot air is believed to pull out the toxins and wax. While ear candles are a popular remedy in the United States and Europe, skeptics argue its claimed benefits are not supported by scientific evidence.

Source: RefillPill.com Editors' Choice