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Manual Cerumen Removal

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1. Manual Cerumen Removal

Manual Cerumen Removal Manual Cerumen Removal Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Manual Cerumen Removal Manual Cerumen (...) Removal Aka: Manual Cerumen Removal , Ear Curette , Cerumen Removal By Instrumentation II. Indications III. Precautions Perform under direct visualization if possible Always keep distance in mind caution in groups at risk for complications External otitis ( , immunocompromised, ) IV. Preparations: Curettes Jobson-Horne loop (wire probe with "O" at end) Buck's #1 cerumen spoon Plastic loops/spoons: unlikely to damage canal V. Management: Manual Removal Technique (effective in 97% children) Steady hand

2018 FP Notebook

2. Cerumen impaction

membrane. Intervention may include manual removal, irrigation, or use of cerumenolytic agents, or a combination of these modalities. After treatment, the clinician should re-examine the patient's ear and document the resolution of the cerumen impaction, and also inspect the previously occluded tympanic membrane. Young children, older patients, cognitively impaired people, and those in nursing homes are at high risk for cerumen impactions. Hearing-aid users are also at increased risk. These groups (...) Cerumen impaction Cerumen impaction - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cerumen impaction Last reviewed: February 2019 Last updated: March 2018 Summary Cerumen is a naturally occurring substance that cleans, protects, and lubricates the external auditory canal. Diagnosed when an accumulation results in symptoms, such as hearing loss, or when it prevents adequate assessment of the ear canal or tympanic

2018 BMJ Best Practice

3. Cerumen Impaction

include ≥1 of the following: cerumenolytic agents, irrigation, or manual removal requiring instrumentation. (8) Clinicians should recommend against ear candling for treating or preventing cerumen impaction. (9) Clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should use additional treatment. If full or partial symptoms persist despite resolution of impaction (...) in the management of cerumen impaction. (3) Clinicians may use manual removal requiring instrumentation in the management of cerumen impaction. (4) Last, clinicians may educate/counsel patients with cerumen impaction or excessive cerumen regarding control measures. Keywords , , , , , Differences from Prior Guideline This clinical practice guideline is as an update and replacement for an earlier guideline published in 2008 by the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF

2017 American Academy of Otolaryngology - Head and Neck Surgery

4. Earwax (Cerumen Impaction)

be treated with an appropriate intervention, including one or more of the following: cerumenolytic agents, irrigation, or manual removal requiring instrumentation. Individuals should be discouraged from using ear candling for the treatment or prevention of cerumen impaction. Individuals should be reassessed at the conclusion of in-office treatment of cerumen impaction and the resolution of impaction should be documented. If the impaction is not resolved, additional treatment should be prescribed. If full (...) be used with the clear understanding that continued research may result in new knowledge and recommendations. These guidelines are only one element in the complex process of improving the health of America. To be effective, the guidelines must be implemented. More About Practice Guidelines More About Practice Guidelines Share this page This page will be removed from your Favorites Links. Are you sure? / / Cerumen Impaction - Clinical Practice Guideline Copyright © 2019 American Academy of Family

2016 American Academy of Family Physicians

5. Risk of Otitis Externa Following Manual Cerumen Removal. (PubMed)

Risk of Otitis Externa Following Manual Cerumen Removal. Based on an interpretation of a recent Joint Commission protocol to sterilize instruments coming into contact with mucous membranes, there has been institutional interest in sterile packaging of cerumen curettes used for manual cerumen removal. To date, there are no studies that have assessed the risk of otitis externa (OE) following cerumen removal and the utility of sterile packaging is questionable. The objective of this study (...) is to assess the incidence of OE following cerumen disimpaction prior to the implementation of sterile packaging at our institution.This was a retrospective chart review. Over a I-year period, 1457 episodes of manual cerumen removal took place in the otolaryngology clinic. Charts were assessed for signs or symptoms of OE within 2 weeks of the procedure through follow-up phone calls and clinic visits in the otolaryngology division.There were no patients who followed up with symptoms or signs suggestive

2014 Rhinology and Laryngology

6. Manual Cerumen Removal

Manual Cerumen Removal Manual Cerumen Removal Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Manual Cerumen Removal Manual Cerumen (...) Removal Aka: Manual Cerumen Removal , Ear Curette , Cerumen Removal By Instrumentation II. Indications III. Precautions Perform under direct visualization if possible Always keep distance in mind caution in groups at risk for complications External otitis ( , immunocompromised, ) IV. Preparations: Curettes Jobson-Horne loop (wire probe with "O" at end) Buck's #1 cerumen spoon Plastic loops/spoons: unlikely to damage canal V. Management: Manual Removal Technique (effective in 97% children) Steady hand

2015 FP Notebook

7. Cerumen Softening Agents

Softening Agents Aka: Cerumen Softening Agents , Ceruminolytic From Related Chapters II. Contraindications s III. Indications Acute with pain or Instill softening agents in ear for 7-14 days May require manual removal of residual debris Prior to a scheduled ear exam (start 2-3 weeks before) Chronic IV. Preparations: Water-based agents Hydrogen Peroxide or Benzalkonium chloride (Zephiran) Mix 1:1 with diluted white vinegar Instill qd-bid for 4-14 days Acetic acid 2.5% (more effective in children) 10 (...) Cerumen Softening Agents Cerumen Softening Agents Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cerumen Softening Agents Cerumen

2018 FP Notebook

8. Cerumen Softening Agents

Softening Agents Aka: Cerumen Softening Agents , Ceruminolytic From Related Chapters II. Contraindications s III. Indications Acute with pain or Instill softening agents in ear for 7-14 days May require manual removal of residual debris Prior to a scheduled ear exam (start 2-3 weeks before) Chronic IV. Preparations: Water-based agents Hydrogen Peroxide or Benzalkonium chloride (Zephiran) Mix 1:1 with diluted white vinegar Instill qd-bid for 4-14 days Acetic acid 2.5% (more effective in children) 10 (...) Cerumen Softening Agents Cerumen Softening Agents Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cerumen Softening Agents Cerumen

2015 FP Notebook

9. Sudden Hearing Loss

show abnormalities. , Impacted cerumen, if present, must be removed prior to establishing a diagnosis in patients with SHL. The Weber and Rinne tuning fork tests have been used traditionally to differentiate CHL and SNHL ( ). , , Several authors, however, have noted that the Weber and Rinne tuning fork test results may not be reliably reproduced between examiners and that the results can be misleading. , - Those same studies also showed than an abnormal Rinne significantly increases the probability (...) Practice Guideline Development Manual, Third Edition” (Rosenfeld et al. Otolaryngol Head Neck Surg . 2013;148[1]:S1-S55), the guideline update group was convened with representation from the disciplines of otolaryngology–head and neck surgery, otology, neurotology, family medicine, audiology, emergency medicine, neurology, radiology, advanced practice nursing, and consumer advocacy. A systematic review of the literature was performed, and the prior clinical practice guideline on sudden hearing loss

2019 American Academy of Otolaryngology - Head and Neck Surgery

10. Otitis Media with Effusion (OME)

clinical practice guideline, the methods outlined in the third edition of the AAO-HNSF’s guideline development manual were followed explicitly. An executive summary of the original OME guideline was sent to a panel of expert reviewers from the fields of general otolaryngology, pediatric otolaryngology, otology, family practice, pediatrics, nursing, audiology, and speech language pathology who assessed the key action statements to decide if they should be kept in their current form, revised, or removed (...) or equipment considerations (eg, inability to obtain an air-tight seal) Difficulty visualizing the tympanic membrane because of partially obstructing cerumen that cannot be readily removed by the clinician Difficulty visualizing the tympanic membrane because of a very narrow or stenotic external auditory canal (eg, Down syndrome) Uncertainty about the presence or absence of OME because of equivocal findings on pneumatic otoscopy Need or desire to rule out OME in an at-risk ( ) child Need or desire

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2016 American Academy of Otolaryngology - Head and Neck Surgery

11. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

and bladder continence is an essential part of the rehabilitation process. Although considerable data on the rate of urinary incontinence exist, there is a paucity of published studies on therapeutic interventions to improve rates of continence. The recommendation to remove indwelling urinary catheters within 24 hours is based on the Centers for Disease Control and Prevention recommendations for all hospitalized patients to prevent catheter-associated urinary tract infections and is not specific to stroke

2016 American Heart Association

13. Tinnitus

, acupuncture, and transcranial magnetic stimulation (TMS). • Secondary tinnitus is tinnitus that is associated with a specific underlying cause (other than SNHL) or an identifiable organic condition. It is a symptom of a range of auditory and nonauditory system disorders that include simple cerumen impaction of the exter- nal auditory canal, middle ear diseases such as oto- sclerosis or Eustachian tube dysfunction, cochlear abnormalities such as Ménière’s disease, and audi- tory nerve pathology such as VS (...) Network www.hyperacusis.net • Support/education for those suffering from sound sensitivity and pain Tunkel et al S21 estimated that almost 23 million older Americans with docu- mented hearing loss did not use hearing aids. A recent review of studies of hearing aid nonuse identified key issues with hearing aid value, amount of perceived benefit, and fit and comfort of the devices. 128 Although minor problems associated with hearing aid use include skin hypersensitivity, cerumen impaction, or recur

2014 American Academy of Otolaryngology - Head and Neck Surgery

14. Acute Otitis Externa

. The etiology of AOE is multifactorial. Regular cleaning of the ear canal removes cerumen, which is an important barrier to moisture and infection. Cerumen creates a slightly acidic pH that inhibits infection (especially by P aeruginosa ) but can be altered by water exposure, aggressive cleaning, soapy deposits, or alkaline eardrops. , Debris from dermatologic conditions may also encourage infections, , as can local trauma from attempts at self-cleaning, irrigation, and wearing hearing aids. , Other factors (...) trials have compared the efficacy of different strategies to prevent AOE. Available reports include case series and expert opinion, which emphasize preventing moisture and water retention in the external auditory canal. Recommendations to prevent AOE include removing obstructing cerumen; using acidifying ear drops shortly before swimming, after swimming, at bedtime, or all three; drying the ear canal with a hair dryer; using ear plugs while swimming; and avoiding trauma to the external auditory canal

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2014 American Academy of Otolaryngology - Head and Neck Surgery

15. Earwax

(the dead flattened cells on the outer layers of the skin), cerumen (a wax-like substance produced by ceruminous glands, which are modified sweat glands), sebum (from sebaceous glands), and various foreign substances (for example cosmetics and dirt) [ ; ; ; ]. Earwax has several functions. It aids removal of keratin from the ear canal (earwax naturally migrates out of the ear, aided by the movement of the jaw). It cleans, lubricates, and protects the lining of the ear canal, trapping dirt and repelling (...) wax if they: Use cotton buds as these push the earwax deeper into the canal. Wear a hearing aid or ear plugs as this prevents the wax being excreted. Although evidence for increased risk of cerumen impaction in people who wear hearing aids is weak. [ ; ; ; ; ; ; ] Prevalence How common is it? In the UK, it is estimated that 2.3 million people each year have problems with earwax which are sufficient to warrant intervention [ ]. Earwax removal is the most common ENT procedure performed in primary

2016 NICE Clinical Knowledge Summaries

16. In Iraq I saved lives. Now, I can’t give an allergy shot.

identified and asked me if they could have their ears flushed out. As an urgent-care physician, removing cerumen impactions is sort of a bread-and-butter procedure. I informed the patient that we would be glad help. The patient then informed me that they had been to their primary care doctor earlier in the day. When confronted with the patient’s request for help with impacted ear wax, the primary care physician told the patient to go to the urgent care. I shook my head “metaphorically” (so (...) the essential principle of osteopathic medicine — we make physical contact with our patients. Some of this is in the form of manual medicine skills to help balance the musculoskeletal, respiratory, lymphatic and digestive systems, and some of this contact is in the form of a thorough, focused physical exam. Some of the contact occurs with a needle. I saved this patient’s life because when he complained of a “cold,” I took the time to visually look at the symmetry of his face and noticed a mass in his neck

2017 KevinMD blog

18. Tympanostomy Tubes in Children

Institute of Clinical Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, Australian National Health and Medical Research Council, and the TRIP database. The search yielded 10 guidelines and 19 systematic reviews or meta-analyses. After removing duplicates, articles not obviously related to tympanostomy tubes, those not indicating or explicitly stating a systematic review methodology, and non–English language articles, 4 guidelines and 15 systematic reviews or meta (...) -analyses remained. A second literature search identified RCTs published between 1980 and March 2012. The following databases were used: MEDLINE, EMBASE, CINAHL, and CENTRAL. The search identified 171 RCTs. After removing duplicates, non–English language articles, and animal model studies, 113 articles remained. The following parameters were used to define the search questions: Population: Children Intervention: Tympanostomy tube insertion, including indications for tube placement, preoperative care

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2013 American Academy of Otolaryngology - Head and Neck Surgery

20. Assistive Devices to Improve Independence (Follow-up)

involve cerumen, cholesteatomas, or acoustic neuromas. These conditions should be recognized and the patient referred to an appropriate subspecialist, such as an ear, nose, and throat (ENT) specialist or a neurosurgeon. Initial otoscopic examination for cerumen or serous otitis is essential. Cerumen obstruction often contributes to hearing loss, and its removal can dramatically improve auditory acuity. This examination should be performed prior to any testing for hearing loss. Otosclerosis or noise (...) -related cochlear damage can be surgically treated with bone removal or , respectively. However, gradual decline in hearing acuity, or presbycusis, is due to degeneration of the organ of Corti, and it can simply be a result of aging. Most people acquire a conductive hearing loss with a narrow range of audibility, an inability to hear high-frequency sound, and difficulty in discriminating complex sounds. Hearing deficits are associated with paranoia, and they can also lead to depression, anxiety

2014 eMedicine.com

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