Medical Editor: Strokina OA, therapist, doctor of functional diagnostics.
September 2019.
The ear plug or sulfuric called a state in which congestion occurs earwax in the ear canal that leads to its obturating (clogging).
ICD-10 code for this pathology is N61.2.
earwax Generation refers to the normal physiological processes. Earwax is a substance which is secreted sulfur glands located in the cartilage compartment of the external auditory meatus. In addition, to the secret data is added glands produce sebum and epithelial exfoliated cells. The components of this mixture are fats, fatty acid salts, minerals and cholesterol. Also in the wax has a substance with an antibacterial effect: immunoglobulins with lysozyme. The functions include earwax ear cleansing, moisturizing and protection of its negative influence of external factors. Removal of sulfur from the hearing organ is made spontaneously at the movement of the temporomandibular joints (chewing, speaking). Simultaneously with the sulfur removed from the ear dust, mud particles, small foreign bodies.
disease prevalence was 4% among adults in Russia and 6% worldwide. The most common disorders are affected adults, children ear plug less common.
Kinds
Conducting inspection to determine the consistency of ear plugs, which is determined by the method of its disposal (a dense concentration of sulfur is more difficult to remove). The following types of caps:
Pasty. It refers to a soft tube. Dark color or light yellow, soft enough, similar to the fresh honey fluid.
Epidermal. The reason for the formation of the pathology is unknown. It consists of epidermal cells (upper skin layer) and sulfur. By color - gray. The consistency of the first moderately loose later hardens. It can cause otitis media.
Plastilinopodobnaya. Also refers to a soft tube. Coloring - brown. The consistency is similar to the soft clay.
Dry. It refers to a solid plug. Coloring dark brown or black. Consistency is very dense.
Causes
Causes of ear plugs are sufficiently numerous and often complement each other:
Invalid hygiene ears. Often enough and rough cleansing ear canal with cotton sticks or sharp objects (Stud, pin) leads to traumatization epithelium outer ear canal, enhance secretion sulfur glands. When exposed to deep sulfur is pushed closer to the eardrum and compacted. Also excessive "hygiene" leads to skin damage cilia external ear canal, and they can not fulfill its function - pushing out the sulfur clusters.
Anatomical features. Congenital or acquired crimp contraction external auditory meatus provoke disorder self-cleaning process of auditory pathways.
Increased secretion of the glands of sulfur. It develops in violation of lipid metabolism, which stimulates the formation of cholesterol. The earwax contains large amounts of cholesterol, which makes it more viscous and violates spontaneous sulfur out of the hearing. Possible genetic predisposition to metabolic disorders or the presence of certain diseases (atherosclerosis).
Inflammatory processes auditory organ. For example, otitis media, ear stimulates the secretion of glands, but the time to be removed, whereby to accumulate to form a plug. Also, when inflammation narrows the lumen of the external auditory canal, and the accumulated sulfur is difficult to leave it.
The use of hearing aids, frequent wearing headphones. Traumatize the skin of the outer ear canal, which provokes increased secretion sulfur accession secondary infection and the development of inflammation in the ear. With continued use of alien objects sulfur is pushed deeper into the external auditory meatus and compacted.
The dense growth of hair in the organ of hearing. Provokes disorder self-cleaning of the auditory meatus of sulfur. Often seen in the elderly.
skin diseases affecting ears (eczema, psoriasis). Stimulate inflammation, epidermal exfoliation, which is further covered by a gray, compacted, forming an ear plug.
The production features (work in a dusty environment). Dust with mud particles settle into the ear canal, enveloping gray. Also sulfur is an increase in the production and operation of external auditory canal skin hairs.
Foreign body in the ear. It enhances the secretion of the glands of ear, not when it is prolonged removal.
Working in over-dried or damp environment. It causes drying of the secret hearing, which forms a solid plug.
Age. Older people have the likelihood of ear plugs increases several times (weaken the defense mechanisms of hearing, increased production of secretion glands).
Frequent water penetration into the ears. It leads to swelling and obturation plug auditory meatus. Common in swimmers.
Clinical manifestations
Often ear plug behaves asymptomatic until completely overlaps the auditory meatus, for example, when water gets in the ear swelling and formation. The presence of the following symptoms may speak in the ears of the conglomerate:
- hearing loss or disappearance of full occlusion of the external auditory meatus;
- Tinnitus is experienced as rustling or stuffy;
- dizziness and headaches;
- syringmus - his voice is given in the ear;
- presence in the ear canal by pulling the ear lumps of sulfur.
On close location to plug the eardrum there is irritation of the nerve endings, which is manifested by nausea, coughing, vomiting. Sometimes there are problems with heart. If a strong pressure on the eardrum conglomerate may receive the psycho-emotional disorders, epilepsy, seizures, paralysis of the facial nerve.
Diagnostics
Differential diagnosis of disease should be carried out with the following conditions:
- Foreign body in the organ of hearing. In the presence of a foreign body of a living patient feels tickling, pain and noise in the ear. Inanimate foreign body by symptoms similar to an ear plug, but also insect and inanimate object in your ear perfectly diagnosed by otoscopy.
- Tumor ear. In addition to the characteristic of the ear plugs disturb the system of the patient signs of dizziness, nystagmus, impaired balance and coordination, autonomic disorders.
- Cholesteatoma. Patients complain of a sense of fullness in the hearing organ, the appearance of a dull, aching, shooting pain or a pressing. Ear drops. Characterized by discharge from the ear in the form of white lumps putrid smell.
In the diagnosis of ear plugs specialist performs otoscopy - examination of the external ear canal with the introduction of his ear funnels and use of the luminaire. In some cases, the physician uses bellied probe with which determines consistency of the formation and its subsequent removal.
Treatment
Diagnosis and removal of cerumen from the ear involved in the doctor - otolaryngologist (ENT). It is strictly forbidden to try to remove ear plug means at hand at home to avoid complications. Only a specialist can determine the consistency of the conglomerate, its magnitude and method of removal. There are several methods eliminate the formation of sulfur from the external auditory meatus.
medical method
It is administered to the organ of hearing means that soften cork or contribute to its dissolution. It called tserumenolizis. The means:
- Made of water-based. This group includes preparations of sea water (Aqua Maurice Oto), solvents (chlorobutanol, glycerol or triethanolamine), 3% hydrogen peroxide solution. The mechanism of action is to soften earwax. Ineffective in the presence of a solid formation or a large size (need mechanical removal).
- Cooked oil-based. This group includes Vaksol (containing olive oil), Remo-Wachs (as part of mink oil), Wedge-Irs (containing wax), preparations with almond and rose oil. Therapeutic effects include softening and enveloping the plug, but do not break it.
- Oil- and water. Carbamide peroxide (in Debroks preparations Auro, Myurayn and others). The mechanism of action is to soften earwax.
- Surfactants. This group applies formulation A cerumen. The surfactants that are surface active agents attached to the sulfuric conglomerate, soften and dissolve it, which helps to remove the ear plugs in the form of liquid secretions from the ear.
- Fitosvechi (fitovoronki). Contain essential oils and propolis. After introduction of the candles in the affected ear it is ignited, burnt out after a certain level to extinguish the candle. Creating a vacuum and thermal effect promotes plug of the external auditory meatus and the exit therefrom. Fitosvechi can be used in children with ear plugs.
Contraindications to the use of drug treatment:
- serous or purulent discharge from the auditory organ;
- damage or suspected injury eardrum;
- allergies to drugs components;
- inflammatory diseases of the ear.
wet removal
This method comprises washing (irrigation) meatus. It is strictly prohibited to carry out on their own. The procedure is painless, but unpleasant. After the patient sitting on a chair on the shoulder by the patient's ear and hoisting trail rubber sheet metal tray. Specialist fills sterile saline (saline or furatsilinovoy) Janet syringe without needle. The tip of the syringe is injected into the affected ear, and then the solution was injected (on the upper wall of the auditory meatus). The solution is heated prior to the procedure to body temperature to prevent reflex responses (nausea, vomiting). Soft tube, usually washed out on the first try. In the presence of dense conglomerate patient appoint instillation into the ear of hydrogen peroxide, three times a day for 2 - 3 days. After instillation of possible hearing loss and the appearance of fullness in the ear, due to swelling of the cork.
Contraindications for washing organ of hearing:
- tympanic membrane perforation;
- acute and chronic otitis;
- the presence of purulent otitis media in the past.
dry method
Tool removal called ear plugs and curettage is used in the formation of a conglomerate of a solid, broken the integrity of the eardrum, after suffering purulent otitis media or by the failure of the washing auditory pass. Is carried out under mandatory visual inspection with the help of surgical instruments (ear hook, ear forceps, ear spoon). After the procedure in the ear for 20 minutes introduced turundas wetted boric alcohol.
complications
Prolonged cerumen in the ear canal causes compression of the eardrum, which can provoke its inflammation (miringit), the development of otitis media and reflex reactions (arrhythmia, heartburn, constipation, headaches and abdominal pain). Rarely ear plug may cause a stenosis (narrowing) the external auditory meatus.
Unauthorized extraction cerumen may cause otitis (otitis media), burns ear tissue injury auditory canal, tympanic membrane perforation, deafness, stop heart.
Prevention and prognosis
Timely removal of ear plugs has a favorable prognosis. Prevention of the state includes:
- Proper hygiene ears. Rejection of cleaning ear canal with cotton sticks and other hard objects. Ear to clean swab dipped in water without affecting the ear canal.
- Inserting ear plugs in their ears. Especially when working in a dusty environment, swimming, diving.
- Treatment of skin diseases (eczema, psoriasis), especially in the localization of the lesions in the ear.
- Regular tserumenolizisa medication holding means (cerumen-A), particularly the tendency to the formation of ear plugs.
- Controlling blood cholesterol (high sulfur production).
