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Manual Cerumen RemovalAka: Ear Curette, Cerumen Removal By Instrumentation

Indications
1. Cerumen Impaction
Precautions
1. Perform under direct visualization if possible
2. Always keep tympanic membrane distance in mind
Curettes
1. Jobson-Horne loop (wire probe with "O" at end)
2. Buck's #1 cerumen spoon
3. Plastic loops/spoons: unlikely to damage canal
Manual Removal Technique (effective in 97% children)
1. Steady hand rests against child's head ALWAYS
  1. Start where cerumen already separated from wall
2. Light touch, work around periphery of occlusion
3. Attempt to remove cerumen in one piece
Ceruminolytics (if manual removal fails)
1. Do not use if Tympanostomy Tubes OR TM Perforation
2. Medication options
  1. See Cerumen Softening Agents
  2. Saline is as effective as other cerumenolytics
3. Technique
  1. A few drops left in ear canal for 15-30 minutes
  2. Then remove with curette OR warm water lavage

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.