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Wax in the Ear.
The conditions which cause the wax to change its quality so as to remain and accumulate in the ear, are not all known. Anything which causes a prolonged irritation of the skin of these parts, seems to cause the wax to harden and thus to prevent its escape.
Symptoms. - The presence of wax in the ear usually induces a gradual impairment of hearing. In most cases there occurs after some time a persistent buzzing or roaring noise in the ear, which may be so severe as to disturb the patient's sleep. Yet, if there be no other unnatural condition present than the mere accumulation of wax, there will probably be no pain. In this way we may distinguish this affection from several others which are accompanied by deafness and roaring in the ears, in which pain is a constant and prominent symptom.
The extent to which wax may accumulate in the ear in some cases, is quite remarkable ; a hard black mass is found filling up the entire ear quite to the surface. Cases are known in which a patient has supposed himself permanently deaf, having suffered a gradual loss of hearing years previously, yet the difficulty has been found to be merely an accumulation of wax in the ear, the removal of which restored the person's hearing perfectly.
Treatment. - The treatment for an accumulation of wax in the ear is essentially the same as that already directed for the removal of a foreign body. The ear must be gently syringed with hot water, the details previously mentioned being most scrupulously observed. It will be advisable to add to the water a little borax or baking soda, in order to soften the wax and thus render its escape easier. We may employ the following mixture :
Borax, ----- Half an ounce.
Water, ----- One pint.
This should be heated so that it feels somewhat unpleasantly warm to the patient at first, and should be injected into the ear in such a way as to permit the escape of the water and the wax. If the first syringing be unsuccessful, the process may be repeated once or twice at intervals of several hours.
If the accumulated wax be in the shape of a plug, as it often is, it will probably be loosened by the syringing and be forced to the orifice of the ear. As this opening is somewhat smaller than the interior of the channel, it may be necessary to extract the plug by means of a forceps. This should be done carefully, without forgetting the possibility of injuring the parts by the instrument. In other cases the wax accumulates at the inner end of the channel, on the surface of the delicate membrane which separates the external from the internal ear. In this case the removal of the wax will be a somewhat more difficult and tedious matter, which can scarcely be accomplished without the assistance of a surgeon.
After the wax has been removed the surface of the skin in the auditory meatus will be for some days quite sensitive and tender ; it is advisable, therefore, to insert into the canal a small plug of cotton which has been well smeared with vaseline. This may be worn for several days, being changed for fresh cotton each day. A patient who puts cotton into the ear should not forget to remove it; sometimes these accumulations of wax are found to have been started by a plug of cotton which had been inserted and allowed to remain in the ear by a careless person.
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