Sulphur plugs in children

Earwax in children is a problem that many parents face. Let's look at the main causes of the pathology, diagnostic methods, treatment and prevention.

Earwax is a secretion that forms in the ears. It protects the inner ear from dust, bacteria and dirt. Normally, various contaminants settle on the wax, which thickens, dries and is removed from the auricle. Earwax plugs form due to increased activity of the sebaceous glands and improper ear care. Using cotton swabs is another cause of plugs. They push the wax into the ear canal and can provoke an inflammatory process.

In most cases, parents are afraid of damaging the ears of a small child and therefore do not treat them correctly. There are about 2,000 sebaceous glands in the external auditory canal, which intensively produce sulfur after birth. The auricle and auditory canal clean themselves during chewing, so they do not require special care. It is enough to wipe the area of the auricle with a cotton swab or towel. But if the child complains of ear pain, then you should urgently contact a pediatrician and otolaryngologist.

Causes of wax plugs in children

Earwax performs protective and cleansing functions, maintains normal humidity levels and prevents the development of fungal and bacterial infections. The causes of earwax in children are most often associated with increased secretion of the sebaceous glands and improper ear care. It is a blockage of secretion in the ear canal.

Let's consider the main causes of pathology:

• Increased sulfur secretion
• Incorrect or inadequate ear care
• Frequent removal of wax
• Using cotton swabs (pushes the secretion into the ear, causing a plug to appear)
• Dry indoor air causes sulfur to thicken
• Anatomical features of the structure of the auditory canal (narrowness, tortuosity)
• Getting water into the ear while swimming (the wax swells and closes the ear canal)
• Foreign objects in the ear
• Various diseases: otitis, eczema, dermatitis, high cholesterol
• Wearing a hearing aid and frequent use of headphones

In children, the plug is dense or pasty, but over time it hardens. If it is not removed in time, it will increase in diameter and completely close the ear canal. Because of this, the child has a feeling of noise and congestion in the ear, hearing is reduced, headaches, nausea, coughing, dizziness are possible.

Pathogenesis

The mechanism of the appearance of a sulfur plug in a child is associated with the work of the sebaceous glands located in the membranous-cartilaginous section of the external auditory canal. Sulfur, that is, the secreted oily liquid, covers the skin of the organ with a thin layer, protecting it from the effects of external irritants. Pathogenesis depends on the cause of the blockage. Incorrect and frequent removal of excess sulfur leads to the appearance of plugs. In most cases, the secretion comes out on its own, during chewing or talking. If its consistency is thicker than normal or the process of excretion is disrupted, then cerumen is formed.

Depending on the consistency of the secretion, there are the following types of earwax plugs:

• Paste-like – dark yellow or light in color with a soft consistency.
• Plasticine-like – dense, brown in color.
• Dry - dark brown or black, hard consistency.

Initially, the sulfur plug is soft and loose, but gradually becomes dense and hardens. Along with this pathology, an epidermoid clot can form from exfoliated scales of the stratum corneum. It has a light gray color, stony density and is adjacent to the walls of the auditory canal, filling its outer part or the entirety.

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Symptoms of wax plugs in children

The organ of hearing consists of the outer and inner ear. The first has two sections: cartilaginous (located at the outlet) and bony (located deep, near the inner ear). Sulfur is produced in the cartilaginous section, but the epithelium of this area is very mobile. Because of this, the secret is released when chewing or talking, cleaning the outer ear. But due to a violation of the cleaning process, symptoms of sulfur plug appear. In a child, they manifest themselves as follows:

• Hearing loss
• Headaches and dizziness
• Nausea
• Paroxysmal cough
• Noise and ringing in the ears

The baby constantly asks what was said again, does not respond to calls. At the same time, a feeling of congestion in the ears and even nose may appear. Symptoms of the disorder are acute after bathing, when water, getting into the ear, provokes an increase in the sulfur clot, which completely closes the ear canal.

Visual examination does not always reveal the true cause of the child's condition. Therefore, it is necessary to closely monitor his behavior. At the first symptoms, it is worth contacting an otolaryngologist. The faster the plug is removed, the lower the risk of complications. This is due to the fact that the vestibular apparatus, responsible for the functionality of the body, is located in the inner ear.

First signs

If a child begins to complain of poor hearing or ear pain, these may be the first signs of a sulfur plug. The disorder occurs due to improper care of the organ of hearing and frequent bathing, which provokes swelling of the sulfur clot.

Signs of pathology:

• Hearing loss
• Headaches
• Nausea
• Dizziness

These symptoms are encountered with otitis, but they can also indicate a sulfur plug. Its presence provokes a violation of the baby's vestibular apparatus. When the first signs of malaise appear, you should contact an otolaryngologist who will prescribe medications to treat the blockage.

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Complications and consequences

Long-term ear congestion and attempts to cope with this problem on your own can cause serious consequences. The absence of medical care is as dangerous as self-medication. An incorrectly performed procedure for cleaning the ear canal from accumulated secretion can cause the following consequences:

• Trauma to the eardrum.
• Inflammation of the outer ear.
• Damage to the epidermis.
• Infection of the middle ear (occurs when there is a perforation of the eardrum).
• Allergic reactions to medications used (when used without a doctor's prescription).

The above-described disorders are in most cases accompanied by fever and chills in the child, headaches, paroxysmal cough. Allergic rashes on the skin, urticaria are also possible. Only professional medical care and timely diagnosis of the problem will help to avoid unpleasant consequences.

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Complications

If the earwax is not removed in a child in a timely manner, hearing problems may begin, which will cause the following complications:

• Hearing impairment.
• Chronic rhinitis/otitis.
• Bedsores of the ear canal (take a long time to heal and cause severe pain).
• Inflammatory and infectious processes.

Every parent should know that removing a clot of ear secretion is a guarantee that the child will not have hearing problems or vestibular disorders. Therefore, at the first signs of pathology, it is necessary to contact a pediatrician and otolaryngologist.

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Diagnostics of wax plugs in children

Constant ear pain and complaints of hearing problems may be associated with increased secretion of earwax and the resulting blockage, so they require medical attention. Diagnosis of earwax blockage in a child begins with an examination by an otolaryngologist.

Diagnostics consists of:

• Collection of anamnesis and analysis of patient complaints. The doctor determines the presence of noise in the ear, headaches, nausea, dizziness, the degree of hearing loss. How often is the auricle cleaned, and whether cotton swabs are used for this.
• Otoscopy is an examination of the external auditory canal and eardrum. The examination may reveal a sulfur plug. In most cases, the clot blocks the canal. Its color ranges from light to dark brown, and its consistency may be dense or soft.

During the examination, a button probe is used. The doctor's task is not only to identify the problem, but also to determine its causes. This will allow choosing the right treatment method and eliminating the blockage without any complications.

Differential diagnosis

When examining a child for earwax, the doctor's task is to recognize diseases with similar symptoms. Differential diagnostics begins with collecting anamnesis, analyzing the patient's general condition, and examining the auricle. Earwax blockage is differentiated from the following pathologies:

• Sensorineural hearing loss (occurs with inflammation of the middle ear).
• Otomycosis.
• Cholesteatoma.
• Otitis (external, internal).
• Mastoiditis (acute inflammation of the mastoid process of the temporal bone).
• Meniere's disease.
• Neuritis of the vestibulocochlear nerve.
• Fungal diseases.
• Foreign body in the ear canal.

An examination during otoscopy reveals a clot of ear secretion. It is light brown to black in color. In particularly advanced cases, it can cause bedsores. To determine the consistency of the plug, the contents are collected using a button probe. After differential diagnostics, the child is prescribed a course of treatment and recommendations for preventing pathology.

Treatment of wax plugs in children

If a child complains of ear pain and hearing problems, these complaints may be due to the fact that the ear canal is blocked by thickened sulfur secretion. In this situation, many parents begin to think about how to remove a child's earwax plug. But it is necessary to take into account the fact that any procedures must be carried out in agreement with the attending physician. In addition, different types of plugs require different approaches to removal.

• Soft clots are removed by rinsing with warm solutions or an electric aspirator.
• In case of a hard plug, washings are contraindicated, as they can provoke its swelling, which will lead to complete blockage of the ear canal. Treatment is carried out by an ENT specialist using special instruments in the procedure room.

That is, removing earwax is not so easy, and if you do it yourself, you can damage the ear canal and cause many problems. Treatment should only be carried out by a qualified doctor.

But if it so happens that waiting for a doctor's visit is problematic, then the procedure for removing sulfur is carried out independently. For this, a special medicine for washing the external auditory canal is needed. For children, the drug A-Cerumen is used, which can be purchased at a pharmacy without a doctor's prescription. So, to wash the right ear, the baby needs to be laid on the left side and dripped into the sore ear. In this position, the child should lie for 1-2 minutes. After this, it is necessary to turn it over and allow the solution to flow out along with the sulfur plug. The same is done for the left ear.

When removing earwax at home, it is strictly contraindicated:

• Try to pull out the clot with a cotton swab.
• Picking around in the ear with tweezers, needles, knitting needles or other objects that may damage the organ.
• Use traditional medicine without first consulting an otolaryngologist.

The above actions can cause the wax to enter the inner part of the ear, making the situation much worse.

Drops for removing earwax in children

Many parents face the problem of earwax blockage. Various methods are used for treatment (rinsing, electroaspiration, mechanical removal). Drug therapy deserves special attention. Drops for removing earwax in children allow you to get rid of the blockage without the risk of damaging the epidermis or eardrum. In addition, they can be used to prevent its occurrence.

Popular and effective drops for removing sulfur clot:

1. A-cerumen

A medicinal product for local use with active ingredients that cleanse the ear canal from earwax and prevent the formation of plugs. The solution is available in 2 ml dropper bottles. 100 g of the preparation contains: 20 g of TEA-cocoyl hydrolyzed collagen, 1.5 g of PEG 120-methyl glucose dioleate and additional components.

• Indications for use: removal and prevention of earwax plugs, ear hygiene in patients with hearing aids. Suitable for patients who frequently use devices attached to the external auditory canal (headphones, telephone headsets), which cause increased production of earwax. Very often prescribed for people involved in water sports and working in dusty areas.
• Directions for use: drip the solution into the external auditory canal, preheating it to body temperature. After use, close the ear with cotton wool for 1-2 minutes, then let the liquid drain and clean the auditory canal. If the sulfur does not come out at once, repeat the procedure within 3-4 days.
• Side effects are possible with individual intolerance to the components of the drug. In rare cases, hyperemia, itching and rash develop at the site of application. Contraindicated for use in the treatment of patients with perforation of the eardrum, chronic infectious and inflammatory lesions. Overdose manifests itself in the form of adverse reactions, passes after discontinuation of the drug.

2. Remo-Wax

A hygienic product for gentle and effective cleaning of the ear canal from various contaminants, softening and removing earwax plugs, and preventing their formation. It is available as a solution in 10 ml bottles. It contains substances that accelerate the separation of dead cells: allantoin, benzethonium chloride, phenylethanol, butylhydroxytoluene, and other components. Penetrants penetrate into the thickness of the earwax clot, softening and washing it out. The medicine does not contain aggressive components or antibiotics, so it is approved for use at any age.

• Indications for use: removal of earwax plugs, hygiene of the ear canal, prevention of earwax and epidermal clots.
• Contraindications: hypersensitivity to the components of the drug, inflammation or pain in the ears, perforation of the eardrum, shunt in the eardrum and 6-12 months after its removal, purulent and other pathological discharge from the ear canal.
• Directions for use: Before inserting the solution into the ear, warm the bottle to body temperature. For ease of use, lie on your side opposite the sore ear. To straighten the ear canal, pull the earlobe down and back. Drop 10-20 drops so that the solution level reaches the transition to the auricle. Cover the ear with cotton wool and lie in this position for 20-40 minutes. Carefully turn over, let the solution drain out and clean the ear canal. It is not recommended to drip drops into the center of the ear, as this may cause an air plug to form.

3. Klin-Irs

An effective preparation for removing earwax. Active ingredients: vegetable paraffin and mint essential oil. It has an oily structure and a pleasant aroma. Suitable for treating patients of any age. Available as a spray and drops of 15 ml and 30 ml. For complete cleaning of the ear and removal of hardened secretion, 3-5 procedures are carried out during the week.

4. Otipax

A combination product in the form of ear drops. It has a disinfectant, local anesthetic and anti-inflammatory effect. Available in a 16 g bottle with a soft pipette. Active ingredients: phenazone 4 g and lidocaine hydrochloride 1 g.

• Indications for use: inflammation of the middle ear, otitis, earwax and other contaminants. Contraindicated for use in case of damage to the eardrum and individual intolerance to the components of the product.
• Directions for use: instill 4 drops of the solution 2-3 times a day. To remove the plug, 2-3 procedures are required with cleaning the ear with warm water afterwards. In case of overdose, hypersensitivity reactions occur, which disappear after discontinuing the medication.

5. Aqua Maris Oto

100% isotonic seawater solution, no preservatives. Prescribed for the prevention of sulfur clots and hygiene of the ear canal in adults and children. The product is instilled into the ears 1-2 times a day or 2-3 times a week, depending on the doctor's instructions and the results of the first procedure. Contraindicated for use in the presence of inflammation and pain, perforation of the eardrum.

Physiotherapy treatment

Many different methods are used to eliminate otolaryngological diseases, but physiotherapy deserves special attention. It is based on the use of natural and hardware techniques that accelerate the recovery process, that is, on the body's reflex response to an irritant. When drawing up a physiotherapy plan for a child's earwax, the following factors are taken into account: the stage of the pathology and its features, the patient's age, the general condition of the body and the history of the disease.

• Most often, patients are rinsed with warm water or antiseptic solutions. This allows the clot of ear secretion to soften. Before the procedure, a warm soda solution is instilled into the sore ear for 10-15 minutes. Rinsing is carried out using a Janet syringe or a regular 20 ml. The stream of liquid is directed along the back wall of the ear canal, pulling the auricle upward and backward. The liquid is injected in a jerky manner under slight pressure. This allows the blockage to be removed in 2-3 actions. After all manipulations, the ear canal is dried with cotton wool and carefully examined.
• Another option for physiotherapy is ear candles. This is an effective treatment for various ENT diseases. They are made from natural ingredients using a special technology. Phyto candles relieve pain, have an antispasmodic and anti-inflammatory effect. The therapeutic effect occurs due to vacuum therapy during the candle burning process. This allows you to soften and remove the sulfur clot, facilitates hearing, improves nasal breathing and local blood microcirculation. They are used under the supervision of a doctor.

The main goal of physiotherapy for the diagnosis of earwax is to relieve the syndrome and stabilize the pathological process.

Folk remedies

The problem of ear congestion has been known for a long time, so there are many methods of eliminating it, each with different effectiveness. Folk treatment is classified as an alternative method that can only be used after a doctor's permission.

Let's look at popular folk recipes for treating earwax in children:

• Put 5-7 drops of almond oil in your ear and cover it with cotton wool. It is better to do the procedure before going to bed, and in the morning clean the ear canal with clean water.
• Take an onion, cut off the top, make a small depression and fill it with dill seeds. The vegetable should be wrapped in foil and baked in the oven until brown juice appears. While the juice is still warm, 3-4 drops are dripped into the ear, covering it with cotton wool. After 6-8 hours, the sulfur clot becomes soft and flows out.
• Place the child on his side and put 3% hydrogen peroxide solution into the sore ear. You need to lie in this position for 2-5 minutes, then turn over and clean the ear canal from wax and medicine residue. To completely remove the blockage, the procedure should be performed 2-3 times a day for 3-5 days. To speed up the whole process, after washing, you can put a warm heating pad under the ear and massage the auricle.
• An analogue of modern phytocandles is a burning wax funnel. Take a piece of fabric and soak it in wax, as soon as it begins to harden, the fabric needs to be twisted into a tube. One end of the funnel is inserted into the ear, and the other is set on fire. It is very important to observe safety precautions: cover the child's head with a thick cloth and make sure that the wax does not get into the ear. During the burning process, sulfur is drawn into the tube. For complete cleansing, 1-3 procedures are carried out.

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Herbal treatment

Another unconventional option for removing a sulfur clot in the ear in children is herbal treatment. A combination of various herbal components will help stop the inflammatory process, soften the accumulated secretion and remove it. Let's look at several herbal treatment recipes:

• Pour 100 ml of milk over 5-10 green poppy heads and boil for 30 minutes. Once the mixture has cooled, strain it and drip 5-7 drops into the ear. A couple of such procedures will help to pull out the plug and relieve inflammation, if any.
• Pour 250 ml of water over 20 g of crushed camel thorn and simmer for 5 minutes. Leave the decoction to brew for 30-40 minutes, then strain. According to the recipe, the medicine is taken orally, ½ cup 2-3 times a day.
• Take equal proportions of oak bark, rhizomes of erect cinquefoil and calamus, thyme. Mix all the ingredients, wrap in a piece of cloth or a handkerchief and dip in boiling water for 3-4 minutes. This herbal remedy is used as a poultice 3-4 times a day to improve hearing and soften ear secretions.
• Grind fresh basil or walnut leaves into a pulp and squeeze through gauze. The resulting juice should be dripped into the sore ear. The therapy is carried out 2-3 times a day. The medicine helps not only with earwax, but also with severe inflammation, otitis.

Homeopathy

An alternative course in medicine is homeopathy, which is aimed at eliminating pathology with the help of drugs that cause the symptoms of the patient's underlying disease. Homeopathic medicines can only be used as prescribed by a doctor. The homeopath selects the remedy, its dosage and duration of use.

Let's look at medications that can be used for children:

• Aconitum napellus – used in the early stages of ear diseases, relieves pain, ensuring normal sleep. Eliminates symptoms of spasmodic cough, nasal congestion and severe thirst.
• Belladonna – helps with severe ear pain, relieves inflammation and fever. It is most often prescribed to children with a reddened and inflamed eardrum. Relieves throbbing pain, colic, discomfort in the throat.
• Ferrum phosphoricum – improves the flow of oxygen to damaged tissues, activating the body's defenses. It is used in the first stages of ear diseases, as it quickly relieves painful symptoms.
• Magnesia phosphorica - used to relieve symptoms of otitis media.
• Verbascum - mullein oil is applied locally, that is, it is dropped into the sore ear. It eliminates the feeling of congestion, removes sulfur and skin plugs. It is not recommended to use in the presence of pathological bloody or purulent discharge from the ear canal.

The dosage of the above-described drugs depends on the severity of the painful symptoms and is selected by the doctor, individually for each patient. As a rule, the treatment lasts for 3-5 days, if there is no improvement during this period, then another drug is prescribed.

Surgical treatment

The method of removing the earwax plug depends on its type and consistency. A child may have a soft, dry, hard or stony earwax clot. Surgical treatment is aimed at removing it without any damage to the ear canal or eardrum. The plug must first be softened with an antiseptic solution or special preparations (A-cerumen, Remo-vax, Debrox). Removal is carried out using a syringe that delivers a stream of water directed into the ear.

If the baby has perforated otitis, then rinsing is not performed, since there is a risk of perforation of the eardrum and complete hearing loss. The clot of ear secretion is removed using a special instrument - a hook probe, that is, a dry method.

Prevention

The key to successful treatment of any disease lies in preventing its occurrence. Prevention of earwax in a child is based on following these rules:

• Timely diagnosis and treatment of any ear pathologies.
• Regular check-ups with an otolaryngologist, especially if you have a tendency to increased wax production.
• Proper hygiene of the ear canal.

It is important to understand that the ears are a self-cleaning organ, and sulfur is a protective lubricant. The secretion is removed from the ear by itself thanks to the natural cleansing mechanism. Hygiene should be limited to washing the initial section of the ear canal and the auricle. You can only remove the sulfur that accumulates at the entrance to the ear, without penetrating deep into it.

To prevent earwax in a child, parents should perform mechanical cleaning of the external auditory canal once a week. It is forbidden to use cotton swabs, since if they penetrate deeply into the ear, they can damage the eardrum. Also, various sharp objects cannot be used when trying to pull out the earwax clot. This significantly increases the risk of serious injuries.

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Forecast

The success of treating ear blockage with sulfur secretion depends on early diagnosis of the pathology. The prognosis is positive in most cases, since immediately after the procedure the child's hearing is restored and discomfort disappears. If there were attempts to independently remove the clot using improvised means or cotton swabs, then most likely this led to trauma to the eardrum. In this case, the prognosis worsens, since there is a risk of hearing loss.

A negative outcome is possible with unreasonable and incorrect use of drugs that soften sulfur. Only therapy prescribed by a doctor will allow painlessly removing the blockage and restoring the patient's normal well-being and hearing.

Earwax in children tends to recur. That is, after the first procedure of its removal, there is no guarantee that it will not form again. To prevent the disease, it is necessary to visit an otolaryngologist at least once every 6 months.

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