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Sulphur plug removal
Last reviewed: 04.07.2025
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Before moving on to the problem of removing earwax plugs, we should dwell on the issues of their prevention. Patients (parents) should be explained that they should not try to remove earwax with cotton swabs, as this leads to its compaction and pushing it deeper into the external auditory canal. The use of sharp objects can lead to injury to the eardrum and the walls of the auditory canal.
Hygienic cotton swabs are intended only for ear care!
The main methods of removing earwax plugs are: curettage, rinsing, use of suppositories, cerumenolysis with various substances - sea water, solvents, oils. However, these methods are not always effective or technically complex, and in a number of conditions (excitable patients, especially children, people with diabetes) they are contraindicated.
Earwax can be safely and easily removed using several methods:
- Under visual control with sufficient lighting, the cerumen can be either aspirated or removed with a curette, or washed out using a Jean syringe (if there is information about an intact eardrum, taking into account the increased compliance and risk of perforation in young children).
- Some drugs help soften or dissolve (A-cerumen) sulfur masses.
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Technique for washing out earwax plugs
The tip of the syringe is inserted shallowly into the ear canal to the posterior superior wall and a uniform stream is directed. The earwax falls out in whole or in parts into a kidney-shaped tray placed under the patient's auricle. If the earwax is not completely washed out, the procedure can be repeated after 2-3 days after repeated use of softening alkaline drops.
Further management
The patient should be informed that in order to prevent the formation of a sulfur plug, they should not carry out independent toilet of the external auditory canal with means that can disrupt the natural evacuation of sulfur masses (usually these are hard wide cotton swabs). Earwax plugs are formed due to improper toilet of the external auditory canal and can lead to temporary hearing loss. Their removal can only be performed during a ENT examination or during lavage.
Removing earwax with medication
Until recently, there were no pharmacological means of cerumenolysis in Ukraine. Currently, our arsenal has been replenished with the drug A-Cerumen (France). A-Cerumen is an aqueous mixture of three surfactants: anionic, amphoteric and non-ionic, which reduce surface tension, dissolve the plug and reduce its adhesion to the wall of the external auditory canal. The product is very convenient for hygiene and prevention - it is enough to use it 2 times a week. In case of sulfur plug, it is recommended to instill 1-2 times a day for 3-5 days. In this case, a gradual lysis of the plug and normalization of sulfur secretion occurs, without the risk of vestibular and auditory disorders.
A-cerumen - a remedy for the prevention and treatment of hypersecretion of earwax and earwax plugs
Compound
- 100 ml of solution contains;
- TEA-cocoylhydrolyzed collagen - 20.0g
- Cocobetaine - 6.0 g
- PEG 120 - methyl glucosadioleate - 1.5 g
- Excipients - qs up to 100 ml
Description and mechanism of action
Light yellowish, slightly viscous, foaming, transparent, odorless liquid. Promotes the dissolution of earwax and facilitates its removal from the auricle.
Indications for use
- Dissolution of earwax plugs.
- Prevention of the formation of earwax plugs,
- Regular ear hygiene (including in cases of increased earwax formation, especially when using hearing aids, telephone headsets and headphones with in-ear fastening, when staying in dusty or humid areas, when engaging in water sports and recreation).
Method of administration and dosage
Open the bottle by turning the top.
To treat the right ear - tilt (in the "lying" position - turn) your head to the left. Press the bottle once to pour A-cerumen (approximately 1/2 of the bottle) into the ear and maintain the position of your head for one minute. Tilt your head (turn - if the treatment is carried out in the "lying" position) to the right and let the dissolved earwax and the remains of the drug flow out freely. Wipe the discharge from the ear with a cotton swab. Repeat the procedure for the other ear (if necessary). To completely cleanse the ear canal, it is recommended to rinse it with warm clean water or a warm 0.9% NaCl solution after A-cerumen.
It is not recommended to use cotton swabs, as they increase the formation of wax and can cause injury to the eardrum.
For regular hygiene and prevention of earwax plugs, use A-cerumen 2 times a week, to remove earwax plugs - twice a day (morning and evening) for 3-5 days.
When using only partially, close the bottle.
It is recommended to use an opened bottle within 24 hours.
Contraindications
- Hypersensitivity to the components of the A-cerumen solution.
- Otitis.
- Perforation of the eardrum.
- Presence of a shunt in the eardrum, as well as in the first 6-12 months after removal of the shunt. Children under 2.5 years of age.
Special instructions
Avoid contact with eyes. Do not swallow.
The bottle and ear canal should be inserted shallowly to avoid irritation. In case of otitis, pain in the external auditory canal, before use in children - be sure to consult a doctor.