Medical expert of the article
New publications
Removing the sulfur plug
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Before moving on to the problem of removing sulfur plugs, we should dwell on the issues of their prevention. Patients (parents) should be told that sulfur should not be removed with cotton buds, as this leads to its compaction and pushing into the interior of the external auditory canal. The use of sharp objects can lead to injury to the membrane and the walls of the ear canal.
Hygienic sticks are designed only for the care of the auricle!
The main methods of removing sulfur plugs: curettage, washing, use of candles, cerumenolysis with various substances - sea water, solvents, oils. However, these methods are not always effective or technically complex, and for a number of conditions (excitable patients, especially children, people with diabetes mellitus) are contraindicated.
The sulfur plug can be safely and easily removed in several ways:
- Under the control of vision under sufficient light, the sulfur plug can be either aspirated or removed by a curette and washed with a syringe by Jean (if there is information about the intact tympanic membrane, taking into account increased compliance and the risk of perforation in young children).
- Some drugs help to soften or dissolve (A-cerumen) sulfuric masses.
[1],
Technique for washing sulfuric cork
The tip of the syringe is introduced shallowly into the ear canal to the posterior surface of the wall and direct a uniform stream. The sulfur plug is completely or partially dropped into the kidney-shaped tray placed under the auricle of the patient. If the sulfur plug is not washed out properly, the procedure can be carried out 2-3 days after the repeated application of softening alkaline drops.
Further management
It should be informed to the patient that, to prevent the formation of sulfur plug, one should not conduct an independent toilet of the external auditory canal with the means capable of disrupting the natural evacuation of sulfuric masses (as a rule, these are solid wide earwaxes). Sulfur plugs are formed with the wrong toilet of the external auditory canal and can lead to temporary hearing loss. Removal of them can be performed only with otpolarolaryngological examination or with washing.
Removing sulfuric cork with drugs
Until recently, there were no pharmacological agents for cerumenolysis in Ukraine. At present, our arsenal has been replenished with A-Cerumen (France). A-Cerumene is an aqueous mixture of three surfactants: anionic, amphoteric and non-ionic, which reduce the 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 apply it 2 times a week. With a sulfuric plug, instill 1-2 times a day for 3-5 days. In this case, there is a gradual lysis of the plug and normalization of the secretion of sulfur, without the risk of vestibular and auditory disorders.
A-cerumen - a means for the prevention and treatment of hypersecretion of earwax and sulfur plugs
Composition
- 100 ml of the solution contain;
- TEA-cocoyl hydrolyzed collagen - 20.0 g
- Kokobetaine 6.0 g
- PEG 120 - methyl glycucosodium dioxide - 1.5 g
- Excipients - qs up to 100 ml
Description and mechanism of action
Light yellowish slightly viscous foaming transparent liquid, odorless. Promotes the dissolution of earwax and facilitates its removal from the auricle.
Indications for use
- Dissolution of sulfuric plugs.
- Preventing the formation of sulfur plugs,
- Regular hygiene of the ears (including with increased ear wax formation, especially when using hearing aids, telephone sets and headphones with ear support, while staying in dusty places or areas of high humidity, while practicing water sports and recreation).
Dosing and Administration
Open the vial by turning the top.
To treat the right ear - tilt (in the "lying" - turn) the head to the left. Once the vial is filled, pour A-cerumen (approximately 1/2 vial) into the ear and keep the head position for one minute. Tilt your head (turn - if the treatment is in the "lying" position) to the right and allow the dissolved sulfuric plug and the remnants of the drug to flow freely. Wipe the discharge from the ear with a cotton swab. Repeat the procedure for the other ear (if necessary). To completely clean the ear canal, it is recommended to wash it after warm A-cerumen with warm clean water or a warm 0.9% solution of NaCl.
Cotton swabs should not be used, as they cause increased sulfur formation and can cause a trauma to the tympanic membrane.
For regular hygiene and preventing the formation of sulfur plugs, use A-cerumen twice a week, to remove sulfur plug - twice a day (morning and evening) for 3-5 days
If partially used, close the vial.
An open vial is recommended to be used within a day.
Contraindications
- Hypersensitivity to the components of the solution A-cerumen.
- Otitis.
- Perforation of the tympanic membrane.
- The presence of a shunt in the tympanic membrane, and also in the first 6-12 months after removal of the shunt. Child age is up to 2.5 years.
Special instructions
Avoid contact with eyes. Do not swallow.
Insert the vial and ear canal should be shallow to avoid irritation. When otitis, tenderness of the external auditory canal, before use in children - always consult with a doctor.