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

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

Different types of cerumen

Cerumen : dry or wet, soft or hard

WET - SOFT

DRY - HARD

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 : Over production Dry type wax Malformation of the external auditory canal (anatomic) 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

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 Definition Obstruction of EAC by cerumen Cartilage Portion Over production of cerumen obstructed Keratosis Obturans keratolitic mass of desquamating squamous epithelium Bony Portion Probably related to faulty migration of squamous epithelial cells pain, otorrhoea
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Location Aetiology

Symptom

THANK YOU

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