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Hi I'm Dr. David Hill and today we are going to be talking about how to remove impacted ear wax. Now ear wax which we call cerenum in medicine is a normal protective function of the ear. It forms both a physical barrier so that the inside of the ear doesn't get injured by dirt or insects. It also forms a chemical barrier against bacteria so normally we are very happy to have ear wax and not having enough of it can predispose people to ear infections like swimmer's ear. Normally ear wax travels out of the ear canal on its own. It is formed in the last half of the ear canal toward the outside and this skin grows outward almost like a little conveyor belt that carries the wax out so usually you don't have to do anything but occasionally with very dry or thick wax or if somebody has been using a Q tip in here you can get what is called an impaction or blockage of the ear canal especially right here where it tends to narrow or bend a little bit. When this is the case you may get pain or outer ear infection or hearing loss. This really needs to be addressed by a doctor. Now there are some things you can do to soften this wax up. There are over the counter medications for example like Debrox or Docusate Sodium that will soften the wax and help it come out on its own. You can also use mineral oil. I would not use vegetable oil because it gets in the ear and goes rancid but that can also soften the wax or you could use a combination of half white vinegar which is acidic acid and half alcohol to help loosen the wax. But if that hasn't done the trick after a day or two or if there is worsening pain or discharge it is time to see a doctor. Doctors have a variety of tools to remove ear wax. In a regular doctor's office they will probably have some form of an ear curet and we're going to look through our otoscope while we are working in the ear to make sure we don't injure anything and make sure we are getting the wax out and not pushing it father in but in some cases that doesn't do the trick. In that case we may use a lavage machine or even just a syringe to push water in the ear if we know the ear drum doesn't have a hole in it. Ear nose and throat doctors will have an operating microscope to see better inside the ear than most doctors can and they will also have a little suction device that allows them to actually suck wax out of there so when the regular doctor can't get the ear wax out from a blockage he or she may ask an ear, nose or throat doctor to help using instruments at their disposal. They may even ask you to instill some medication in the ear and come back in a week or two for a repeat cleaning of the ear. The good news is most people don't get these blockages and if you just see a little wax in the ear give it a little time and it is likely to work its way out on its own. I am talking about how to remove any impaction of ear wax, I'm Dr. David Hill.