What are the contraindications for cerumen impaction removal?

Updated: May 09, 2018
  • Author: F Carl van Wyk, MB, ChB, MRCS, FRCS(Edin); Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Specific contraindications exist for each specific procedure. Individual assessment should dictate which technique is the most appropriate [16] .

  • Contraindications to irrigation include the presence or history of a perforated tympanic membrane, previous pain on irrigation, or previous surgery to the middle ear and in the presence of a discharge. In the case of a pediatric patient you will also need a cooperative patient and supportive parent.
  • A relative contraindication to probing is the inability to visualize the ear canal.
  • Relative contraindications to the use of visually directed micro-suction include severe previous exacerbation of tinnitus, very hard cerumen, and an uncooperative patient.
  • Exceptional caution has to be used when clearing cerumen in patients who have undergone a mastoidectomy in the past, during which sensitive anatomical structures like the facial nerve and semicircular canals may have been exposed.

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