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PubMedDate not supplied

Has cerumen a protective role in recurrent external otitis?

PURPOSE: We investigated the bactericidal activity of the cerumen in patients with recurrent otitis externa. MATERIALS AND METHODS: Cerumen samples were collected from 2 groups. Group A (n = 20) consisted of patients with recurrent otitis externa (2 or more acute otitis externa attack in the current year) and group B (n = 30) consisted of cerumen from a healthy population. We examined the bactericidal activity against the common microorganisms (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus) that encounter the recurrent otitis externa. RESULTS: A significant decrease in the count of S epidermidis was observed in group A (P <.05) and B (P <.01) was observed. A comparison of decreases and increases in the percentages of microorganisms between the groups A and B showed that there was a significant difference only in the count of E coli (P <or=.05). The count of E coli decreased in cerumen suspension in group A, but it increased in the normal population. CONCLUSION: We did not confirm that cerumen from patients with recurrent otitis externa had less bactericidal activity than from a healthy population.

Cerumen↗
PubMed2005

Detection of HCV-RNA in cerumen of chronically HCV-infected patients.

OBJECTIVES/HYPOTHESIS: Viral hepatitis C is a worldwide public health problem. Hepatitis C virus is mainly transmitted by parenteral or percutaneous route. Nonparenteral transmission, such as through sexual activity, household contact, and vertical or perinatal exposure to body fluids or secretions, can occur, which has been studied before. Cerumen, however, has not been investigated for its ability to transmit hepatitis C virus. The aim of this study is to evaluate the importance of cerumen in transmission of hepatitis C virus infection. STUDY DESIGN: This study was performed on 35 patients with confirmed chronic hepatitis C virus infection. METHODS: Thirty-five cerumen specimens collected from the patients with hepatitis C virus RNA in their sera were prospectively analyzed for the presence of hepatitis C virus RNA by polymerase chain reaction. RESULTS: None of the 35 cerumen specimens were positive for hepatitis C virus RNA. CONCLUSION: This study showed that cerumen has no risk for transmission of hepatitis C virus infection, even in patients with high hepatitis C virus RNA serum levels; however, standard infection control precautions should be applied carefully in all examinations and surgical operations of the ears.

Body Fluids↗
PubMed2004

Microbiology of cerumen in patients with recurrent otitis externa and cases with open mastoidectomy cavities.

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media. Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects. The mean of the microbial count was 3.4 x 10(4) in group A, 3.08 x 10(4) in group B and 2.48 x 10(4) in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In group B antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples, the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C. In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.

Adolescent↗
PubMed1981

Management of the ear canal seborrhea with cerumen.

For the past 20 years, the author has been treating recurrent chronic seborrheic dermatitis with a suspension of human cerumen in glycerine. The cerumen is obtained from healthy children and young adults in which there is an over-production which requires removal. If the cerumen contains debris it is not used. The collected cerumen is suspended in 50% glycerine and left for several weeks to sterilize. It is then strained through a fine filter having been heated so that its is workable. The material is dispensed to the patient in a small dropper bottle and the patient is instructed to place two drops in the external ear canal once a week. The chronicity of seborrheic dermatitis must be explained carefully to the patient and the necessity for avoiding water, cosmetics and other materials must be stressed. The patient must be made aware that the cause of the condition is unknown and that periodic inspection of the ear canal is necessary in addition to the topical application of the cerumen suspension.

Cerumen↗
PubMed1995

Effect of cerumen on infrared ear temperature measurement.

This pilot study examined whether the occlusion of one ear canal with cerumen affected the usual temperature difference between the ears as measured with an infrared thermometer. Ear-based temperature measurements were made in 14 elderly nursing home residents before and 3 to 4 days after irrigation to clear cerumen from the occluded ear. The presence of cerumen tended to lower the temperature reading, with a mean change of -0.24 +/- 0.47 degrees F (-0.13 +/- 0.47 degrees C, p = 0.08) and individual differences ranging from -0.9 to 0.4 degrees F (-0.5 to 0.2 degrees C), 43% of subjects (6/14) had values lower by -0.5 degrees F (-0.3 degrees C) or more. The advantage of removing impacted cerumen before making infrared ear temperature measurements may be offset by the time and inconvenience of the irrigation procedure. Improved hearing may be a more important outcome of cerumen removal, with secondary benefit for temperature measurement.

Aged↗
PubMed2006

Role of impacted cerumen in hearing loss.

We performed a study to determine if cerumen in the ear canal causes significant hearing loss and to ascertain if there is any correlation between the amount of cerumen and the degree of hearing loss. Our study was conducted on 109 ears in 80 patients. The results indicated that impacted cerumen does cause a significant degree of conductive hearing loss. We found no significant correlation between the length of the cerumen plug and the severity of hearing loss. Nor did we find any significant correlation between the presence of impacted cerumen and variables such as age, sex, ethnicity, or affected side.

Acoustic Stimulation↗
PubMed2003

Randomized clinical trial of docusate, triethanolamine polypeptide, and irrigation in cerumen removal in children.

BACKGROUND: Cerumen obstructing visualization of the tympanic membrane in children is a common and frustrating problem. Docusate sodium, triethanolamine polypeptide, and saline were compared to determine their effectiveness in relieving cerumen obstruction in children. METHODS: A randomized, controlled, double-blind trial was performed on pediatric patients aged 6 months through 5 years with cerumen obstruction. The enrolling physician determined whether the cerumen completely or partially obstructed visualization of the tympanic membrane. One milliliter of docusate sodium, triethanolamine polypeptide, or normal saline as control was placed into the patient's ear canal. If the tympanic membrane was not completely visualized after 15 minutes, the ear was irrigated with 50 mL of tepid water. Irrigation was repeated a second time if needed. The main outcome was the proportion of tympanic membranes that were completely visualized after cerumeno-eblytic agents or control saline, alone or with irrigation if needed. RESULTS: Of 92 patients enrolled, 34 received docusate sodium; 30, triethanolamine polypeptide; and 28, saline. Mean +/- SD patient age was 34.7 +/- 18.1 months, and 50 (54%) of the patients were girls. Groups were similar in age, race, sex, ear enrolled, wax consistency, and degree of obstruction. There was no significant difference in the proportion of tympanic membranes completely visualized after treatment with docusate (18/34; 53%), triethanolamine polypeptide (13/30; 43%), or saline (19/28; 68%) (P =.17). CONCLUSION: Application of docusate sodium or triethanolamine polypeptide did not significantly improve the proportion of tympanic membranes that were completely visualized vs application of the saline control.

Cerumen↗
PubMed1986

Possible influence of age on the expression of the heterozygous cerumen phenotype.

The relationship of cerumen (earwax) phenotype and age was examined in 2,618 women. An increasing proportion of white women with dry or unclassifiable cerumen was found with advancing age, ranging from 2.0% in women under 30 years to 13.3% in women 70 years and older. No statistically significant change with age was found in other racial groups. It is suggested that the increase of dry or unclassifiable cerumen in white women represents a change in the expressivity of alleles that determine cerumen type occurring with advancing age in women who are heterozygous for the trait.

Adult↗
PubMed1990

Composition of cerumen lipids.

Lipids were extracted from "wet" cerumen and analyzed by quantitative thin-layer chromatography to determine their composition. The lipid fraction comprised 52% of the dry weight of cerumen and consisted of squalene (6.4%), cholesterol esters (9.6%), wax esters (9.3%), triacylglycerols (3.0%), fatty acids (22.7%), cholesterol (20.9%), ceramides (18.6%), cholesterol sulfate (2.0%), and several unidentified polar components (7.5%). In addition to the extractable lipids, the residue contained an additional 0.9% lipid that could be released only after saponification. This covalently bound lipid consisted of two unusual ceramides (63.4%), omega-hydroxyacids (27.7%) and nonhydroxy fatty acids (8.8%). The composition of this bound lipid resembled that recently found in human stratum corneum, which is thought to comprise a lipid envelope on the outer surface of the corneocytes. The free and covalently bound lipids may be significant determinants of the properties of cerumen. Desquamation of corneocytes and their associated lipids from the epidermal lining of the ear canal may make a major contribution to cerumen.

Cerumen↗
PubMed1995

[Dimorphism of cerumen, facts and theory].

¿Dimorphism¿ means the existence of two phenotypic different types of the human cerumen and morphology of the cerumen glands. In this paper, the morphological, biochemical, and functional differences are reviewed. The wet cerumen is better adapted to a hot and humid climate where infections of the outer ear are very frequent and sometimes severe. In a cold and dry climate, the dry cerumen is advantageous. In the moderate climates, both types are equivalent (balanced dimorphism).

Cerumen↗
PubMed1995

Cerumen occlusion lowers infrared tympanic membrane temperature measurement.

OBJECTIVE: To examine the effect that cerumen occlusion of the ear canal has on infrared tympanic membrane temperature measurement. METHODS: A prospective, randomized, single-blind human study was carried out in a university hospital observation unit. The subjects were a convenience sample of human volunteers ages 18 years or older who did not have cerumen occlusion or scarred tympanic membranes. A paraffin-coated human cerumen plug was placed in one randomly chosen ear, and after 20 minutes of equilibration the temperature of each ear was measured with an infrared thermometer. Analysis of the difference in mean temperature between the occluded and nonoccluded ears was by Student's paired t-test. RESULTS: Infrared tympanic membrane temperatures were measured in 43 subjects aged 21 to 58 years. The mean temperature of the occluded ear canal was 0.3 degrees C lower than that of the opposite ear canal (p = 0.0001, 95% CI 0.16-0.45 degrees C). CONCLUSION: Cerumen occlusion of the ear canal causes underestimation of body temperature measure by infrared tympanic membrane thermometry.

Adult↗
PubMed1985

Impacted cerumen as a reason for failure in hearing conservation programs.

To test the hypothesis that children with impacted cerumen experience more hearing or middle ear problems than children with normal cerumen, two serial audiometric screenings including otoscopic examinations, tympanometry, and audiometry were conducted. Thirty children with impacted cerumen and 30 children with normal cerumen were rescreened three months after the initial screening. Results suggest an association between impacted wax and subsequent problems.

Audiometry↗
PubMed1986

A technique for measuring the rate of cerumen production.

A technique is described for quantitatively measuring the rate of cerumen production. Two different washing solutions were tried. A mixture of alcohol/ether (3:1 v/v) appeared to be the best extracting solution yielding 2.05 +/- 0.22 versus 0.73 +/- 0.14 mg/week per ear obtained with Triton X-100 solution. In addition, reproducibility was definitely better. Triton X-100 may be useful whenever microbiologic evaluations are requested. Total lipids accounted for 73.3% of cerumen extracted with the former solution, triglycerides being 19.5%, and cholesterol 7.2%. Our extracting technique appears to be a good estimate of the cerumen global output and may supply important information about cerumen in several biologic conditions.

Adult↗
PubMed1995

Cerumen impaction in the elderly.

1. Cerumen impaction is a reversible cause of conduction hearing loss in the elderly. 2. Risk factors include ear canal hairs, hearing aids, bony growths secondary to osteophyte or osteoma, and a history of impacted cerumen. 3. Cerumen removal can cause damage to the external auditory meatus, perforation of the tympanic membrane, and/or otitis media. 4. Methods to remove cerumen impactions include: ceruminolytic agents, curette methods and lavage method.

Aged↗
PubMed1988

Studies on hexachlorocyclohexane and DDT contents in human cerumen and their relationships to cancer mortality.

Organochlorine pesticides in cerumen were used as a biological marker to monitor the exposure of organochlorine pesticides in the human body. The amount of sample used was about 10 mg. The order of magnitude of HCH (hexachlorocyclohexane) isomer content in cerumen was beta greater than alpha greater than gamma greater than delta; for DDT, the order was p,p'-DDE greater than p,p'-DDT. There was little o,p'-DDT and p,p'-DDD. The contents of beta-HCH and p,p'-DDE in cerumen were highly significantly correlated with those in adipose tissue of the same individuals. Approximately 3800 cerumen samples collected from 35- to 54-year-old healthy adults in the general populations of 35 counties were analyzed for HCH and DDT. The accumulation levels of beta-HCH had a geographical character with obvious gradient differences, and the levels were higher in males than in females. The accumulation levels of beta-HCH in the populations studied were highly significantly correlated with the mortality rates from liver cancer, colon/rectum cancer, and lung cancer in males as well as colon/rectum cancer in females (P less than 0.01), suggesting that the effect of HCH on the above cancers should be studied further.

Adipose Tissue↗
PubMed1997

Cerumen impaction.

Cerumen impaction represents the most common otologic problem encountered by physicians. It can affect up to 6% of the general population and a much higher percentage in the mentally retarded population. Cerumen is a mixture of secretory products of two glands in the external auditory canal where it serves a protective function. The external auditory canal possesses a unique anatomy and physiology that permits an efficient self-cleaning system. In most cases, a breakdown in the epithelial migration of the external auditory canal is thought to cause cerumen impaction. The management of cerumen impaction include direct removal, irrigation, and the use of cerumenolytics.

Cerumen↗
PubMed1983

Cerumen phenotype and epithelial dysplasia in nipple aspirates of breast fluid.

The relationship between presence of dysplastic epithelial cells in nipple aspirates of breast fluid and wet or dry cerumen phenotype was studied in 1,150 white and Asian American women. A statistically significant greater proportion of premenopausal white women of wet cerumen phenotype, compared to women of the dry cerumen type, was found to have cytologic dysplasia (relative risk 6.5 [1.8--22.3]). The effect was not observed in postmenopausal women. The finding offers new support for our hypothesis that an apocrine genetic factor affecting breast gland secretion may influence exposure of the breast epithelium to potential carcinogenic substances of exogenous or endogenous origin.

Adult↗
PubMed1996

Prevalence of otitis media, hearing impairment and cerumen impaction among school children in rural and urban Dar es Salaam, Tanzania.

Eight hundred and two (802) primary school children in rural and urban Dar es Salaam, Tanzania, were examined to determine the prevalence of otitis media, hearing impairment and cerumen impaction by otoscopy and pure tone audiometry. Ear disease was found in 222 (27.7%) of the children. One hundred and twenty six (15.7%) had cerumen impaction, 70 (8.7%) had sensorineural hearing loss and 21 (2.6%) had chronic suppurative otitis media. Cerumen impaction was found in 20.45% of the rural school children and in 14.8% of the urban school children. This difference in prevalence between the two groups was not statistically significant. The prevalence of chronic suppurative otitis media (COM) was 9.44% among the rural school children and 1.3% among the urban school children, the difference being statistically significant (P < 0.001). Sensorineural hearing impairment was found in 14.1% of the rural school children and in 7.7% of the urban children, this also being statistically significant (P < 0.05). The low prevalence of chronic suppurative otitis media among the urban school children is ascribed to better medical services which facilitate early diagnosis and treatment of acute otitis media. This emphasizes the need to improve the health services in the rural areas so that acute otitis media is diagnosed and treated at the primary level of health care. This will in turn prevent hearing impairment due to chronic suppurative otitis media.

Adolescent↗