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Cerumen Prop
Dr. Tolkha Amaruddin, M.Kes, SpTHT
RSUD SARAS HUSADA PURWOREJO 2008
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Definition
Cerumen prop : obstruction of the EAC by cerumen
The term cerumen earwax
Cerumen the secretory product of the ceruminous glands in the
EAC, its just one component of earwax
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Physiology
Ear wax : mixture of secretions of the ceruminose &
pilosebaseus glands, squames of epithelium, dust & other
foreign debris located in the cartilaginous portion of the ears
canal. Protection acid condition : PH 6
Transport of debris
Lubricant
Bactericid efect
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Different types of cerumen
Cerumen : dry or wet, soft or hard
DRY - HARD WET - SOFT
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Pathophysiology
Its quantity varies individually & its consistency is
determined by proportions of mixture
In a normal condition cerumen can migrate from canalis auditory
external in flake by open the mouth and mastication
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Cause of obstruction :
1. Over production
2. Dry type wax
3. Malformation of the external auditory canal (anatomic)
4. Cleaning the ear inappropriatly push the cerumen posteriorly
impaction
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Symtomps :
Hearing impairment (deafness) CHL
Earache
Reflex cough
Fullness in the ear
Tinitus vertigo
Objective
Finding the cerumen in the canalis
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Treatment
1. Ceruminolytics
Epithelial acumulation desquamation & debris collection.
A ceruminolytic disrupt the structural integrity of the keratin
sheets and thereby soften, loosen, liquefy, &/ dissolve cerumen
and perhaps even float it out.
The integrity of the cell membrane , which
allows water to pass into the corneocytes along an osmotic
gradient.
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2. Technique Instrumentation
2.1. Syringing
2.2. Suction
2.3. Hooking under direct vision.
A careful history:
tympanic membrane perforation
previous ear surgery
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Education
Do not to attempt self removal of cerumen with the use of any
devices such of: cutton bud, and hairpins:
1. Increase impaction
2. Secondary infection
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Cerumen Prop vs Keratosis Obturans
Cerumen Prop Keratosis Obturans
Definition Obstruction of EAC keratolitic mass of
by cerumen desquamating
squamous epithelium
Location Cartilage Portion Bony Portion
Aetiology Over production Probably related to
of cerumen faulty migration of
squamous epithelial cells
Symptom obstructed pain, otorrhoea
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