1What are the exclusions for self-treatment?
signs of infection
pain w/ ear discharge
bleeding/trauma
ruptured tympanic membrane
ear surgery within last 6 weeks
tympanostomy tubes
incapable of following instructions
hypersensitivity to recommended agents
<12 years old
3What is cerumen a mixture of?
secretions from the ear canal & sloughed epithelial cells
4What is the functions of cerumen?
lubricates canal
traps dust & foreign materials
waterproof barrier
antibacterial properties
5What are signs of excessive or impacted cerumen?
sensation of ear fullness, dull pain, or itching
can also see tinnitus, dizziness, vertigo, cough, & hearing loss
6What are the risk factors for excessive or impacted cerumen?
hearing aids
earplugs
headphones
cotton swabs
7What are the treatment options for impacted cerumen?
cerumenolytic agents w/ or w/o irrigation
manual removal by provider
observation
8What is the cerumen-softening agent?
carbamide peroxide 6.5% in anhydrous glycerin
-the only FDA approved agent
9What age group can use carbamide peroxide 6.5% in anhydrous glycerin?
12 years & older
10How often should carbamide peroxide 6.5% in anhydrous glycerin?
5-10 drops BID PRN up to 4 days
11What are examples of water-based cerumen-softening agents?
choline salicylate
potassium carbonate
distilled water
saline
phenazole
urea peroxide
docusate sodium
12What are oil-based cerumen-softening agents?
almond oil
benzocaine
chlorbutanol
triethanolamine polypeptide
13What can be attempted alone or in combo with a cerumenolytic?
irrigation
14What product should be used for irrigation?
sterile water
15When should manual removal be performed?
only if earwax has migrated to the outer external ear canal
only for adult use
16What are the causes of water-clogged ears?
shape of ear canal & excessive cerumen
excessive moisture
cotton tips, headphones, etc
17What can water-clogged ears lead to?
tissue maceration, which can cause itching, pain, inflammation, & infection
18What is swimmer's ear?
an infection of the external auditory canal
"otitis externa"
19What are non-pharmacological approaches for water-clogged ears?
earplug products: leave in canal 5-10 minutes after swimming to absorb any trapped water then discard
pull gently on ear lobe while tilting head downwards
use blow dryer on lowest setting pointed towards ear canal
20What is the pharmacological treatment for water-clogged ears?
isopropyl alcohol 95% in anhydrous glycerin 5%
-only FDA approved "ear drying agent"
21What is a home remedy for water-clogged ears?
50:50 mixture of acetic acid (white vinegar) & isopropyl alcohol 95%
-has bactericidal & antifungal properties
-lowers pH of ear
22What should you not use for water-clogged ears?
cider vinegar