Sulfur plug - what is it and how to remove it?
Sulfur plug - what is it?
Sulfur plug is a dense formation of sebum and sulfur. All of these foods are produced by the ear glands.
The sulfur plug includes cells of the desquamated epithelium lining the external auditory canal. It also contains dust particles.
The cork can be of different colors. Sometimes it is yellow and sometimes it is dark brown. At first, the cork is soft, and then it becomes dense and can resemble a stone.
Sulfur plug is formed in about 4% of the inhabitants of Russia and in 6% of the world's inhabitants. It is most often found in adults. Sulfur plug in childhood is a rare phenomenon.
Although statistics indicate that this problem is not very common in modern society, doctors say the opposite. In their opinion, the statistics are significantly underestimated. There is evidence that during life, almost every person at least once encounters a sulfur plug.
There are some interesting facts about earwax that simply cannot be ignored:
- In the Middle Ages, sulfur was used as a lip care agent. She was also used to write ancient manuscripts.
- Sulfur from female ears has a higher acidity than male sulfur.
- The composition of this substance differs not only depending on the sex of a person, but also on his race. So, in Asians, sulfur is low-fat and dry, while in African Americans it is soft and contains a lot of fat.
History itself proves the fact that the ears have the ability to self-purge from wax. The described situation happened at the beginning of the twentieth century. In one Chinese man, a bamboo chip damaged the integrity of the eardrum. They tried to remove it, but each attempt ended in failure, as the chip opened and could completely tear the membrane. Then the man was left alone and decided to just watch him. The ear was not inflamed. Over time, the chip approached the edge of the tympanic membrane, and then went out along the wall of the ear canal. In this case, no signs of damage remained in the ear.
- How the outer ear works
- What's in earwax? Why does a person need it?
- How do the ears self-cleaning wax?
- Reasons for the appearance of sulfur plug
- Symptoms of sulfur plug
- How to remove sulfur plug from the ear?
- Hydrogen peroxide to remove sulfur plug
- Ear rinsing to remove wax plug
- 4 Medical Methods to Remove Wax Plug from the Ear
- Devices for removing sulfur plug
- How to prevent the formation of a sulfur plug?
How the outer ear works
The outer ear is represented by the auricle. It is an elastic cartilage that is covered with skin. The ear canal is located on the side of the shell. On its sides are two cartilaginous protrusions.
The external auditory canal originates outside the auricle. Its end point is the eardrum. The ear canal has a slight curvature and two sections. The first is located closer to the exit and consists of cartilage and a membrane, and the second is located next to the eardrum and is represented by bone tissue. These two passages are separated by an isthmus.
The membranous cartilaginous passage is covered with hairs, and glands are also present in it. Some produce sulfur, others produce lard, and still others produce sweat. In just 30 days, the sulfur glands produce about 20 mg of sulfur.
The bony part of the ear canal has no glands.
What's in earwax? Why does a person need it?
Sulfur contains fats, cholesterol, wax esters and unsaturated fatty acids. This composition of sulfur does not allow it to dissolve in water, but at the same time it provides lubrication to the dermis lining the ear canal, protects it from dust and drying out.
Earwax contains antibacterial components, as well as lysozyme. It destroys the microbial wall. It also contains immunoglobulins, which help maintain local immunity. All these sulfur components, as well as the acidic environment in the external auditory canal, are reliable protection of the internal structures of the ear from pathogenic flora.
Sulfur production is a natural process that the body needs to defend against external attacks.
How do the ears self-cleaning wax?
The external auditory canal communicates with the inside of the temporomandibular joint. While a person is talking or chewing food, sulfur moves from the eardrum to the outside.
The skin lining the ear canal grows as quickly as human nails. As it grows, it pushes the ear secretion outward. Thus, the sulfur, which is attached to the eardrum, after 2-3 months will independently appear near the exit from the ear canal.
In addition, the auditory tube is covered with fine hairs that are in motion all the time. Their vibrations also push the earwax out.
However, the self-cleaning mechanism of earwax can sometimes fail, leading to the formation of a waxy plug.
Reasons for the appearance of sulfur plug
There are the following factors that lead to the formation of an ear plug:
Violation of hygiene rules. If a person too often uses cotton swabs to clean the ear canal, or uses sharp objects, for example, toothpicks, for this purpose, this will lead to the formation of a sulfur plug. By such actions, he injures the skin, in response to which the sulfur glands begin to work more actively. Earwax is pushed into the canal and compacted. As a result, self-cleaning becomes impossible.
Too rough movements with a cotton swab lead to damage to the cilia of the external auditory canal, so they are no longer able to perform their functions as expected.
Features of anatomy. Sometimes a person's ear canal is too narrow or tortuous from birth. This becomes an obstacle to ear wax self-cleaning. Such anatomical features can be either congenital or acquired. The shape of the ear canal may change as a result of injury.
Increased separation of earwax. If the lipid balance in the human body is disturbed, this leads to an increase in the amount of cholesterol in the ear canal. This substance is found in earwax. It acquires an increased viscosity, the process of its removal from the ear is difficult. Metabolic disorders can be a hereditary pathology, or develop against the background of certain diseases, for example, with atherosclerosis.
Inflammation and infectious diseases affecting the external auditory canal. Any diseases of the outer ear lead to the fact that the sebaceous and sulfur glands activate their work. As a result, the ear simply does not have time to cope with such volumes of sulfur. In addition, there is a narrowing of the ear canal due to inflammation and edema of its tissues. This is a mechanical barrier to the release of sulfur.
During illness, the qualitative composition of earwax changes. It contains less lysozyme and immunoglobulins, which leads to secondary damage to the ear glands, and the course of inflammation only aggravates.
Wearing a hearing aid. The hearing aid rubs the skin of the ear canal, in response to this, the sulfur glands begin to produce more sulfur. A similar situation can be observed with frequent use of headphones. The sulfuric secretion is pushed into the deep structures of the passage and compacted. Also, this factor can provoke the development of inflammation.
Excessive hair growth in the ear canal. When there is too much hair in the ear canal, it will interfere with the normal flow of wax through it. Most often, this problem is observed in older people.
Diseases of the skin of the external auditory canal. If the patient suffers from psoriasis or eczema, then the epidermis of the skin of the ear canal is exfoliated in excess, mixes with sulfur, thickens and blocks the outlet. Also, against the background of non-infectious inflammation, the work of the sulfur glands increases, which aggravates the problem.
Work in dusty rooms. If a person works in a mine, in a mill or in another production where there is a lot of dust, then it will surely settle in the ear canal and disrupt the work of his cilia.
Foreign body entering the external auditory canal. If there is any foreign body in the ear canal, the glands will produce more secretion to get rid of it. As a result, a sulfur plug may form. Moreover, for self-cleaning of the passage there will be an obstacle in the form of this foreign object.
Prolonged time spent indoors with dry air. If the air humidity drops to 40% or less, then the skin of the ear canal will dry out. As a result, a hard sulfur plug will form.
Age features. As the body ages, the mechanisms for cleaning the ear from secretions deteriorate, and its production increases. An increase in the amount of hair in the ears also contributes to the formation of plugs.
Video: causes of sulfur plug and methods of treatment:
Symptoms of sulfur plug
For a long time, a person may not be aware that there is a sulfur plug in his ear, since it does not manifest itself in anything. The first signs of its presence can occur only when the ear canal is 70% blocked. If a plug has formed in two ears, then the symptoms will be bilateral.
The following symptoms indicate sulfur plug:
- Hearing impairment, ear congestion feeling. Earwax gradually accumulates in the ear, so hearing loss will progress all the time.
Prolonged dry cough, dizziness, nausea, pain and echoes of one's own speech. These symptoms develop when a sulfur plug puts pressure on the eardrum. It contains nerve endings that will be irritated. If you ignore these signs, then a person may experience myringitis. This term is called inflammation of the tympanic membrane. It also increases the likelihood of otitis media. Ear pain will get worse, especially when you move your jaw. The body temperature may rise, and uncharacteristic discharge will appear from the ear.
- Heart rhythm disturbances, facial nerve palsy, epileptic seizures. These symptoms occur when a plug forms in the bony part of the ear and puts strong pressure on the eardrum. After getting rid of the plug, the symptoms will be stopped.
Most often, the first signs indicating the formation of a plug manifest themselves after contact with water. It increases in size and moves closer to the tympanic membrane, which causes the occurrence of the corresponding symptoms.
How to remove sulfur plug from the ear?
To get rid of the sulfur plug, you can use special tools and carry out the procedure at home, or visit the doctor's office and undergo appropriate therapy.
How to remove sulfur plug at home?
If the symptoms of the presence of sulfuric plug are quite intense, then this indicates its impressive size. It is not recommended to remove such formations at home, as there is a possibility of infection in the ear. As a result of incompetent actions, a person can damage the skin of the ear canal or eardrum.
Small plugs can be removed from the ear canal by yourself, but taking all precautions. It is best to use special preparations for this purpose, and not cotton swabs.
Can cotton swabs be used?
The deeper a person inserts a cotton swab into the ear canal, the more the wax is compacted. This will lead to the fact that it will become larger and more difficult to get rid of.
The stick can damage the skin of the ear canal and even the eardrum itself, so they cannot be used.
Drops for dissolving the plug in the ear
To remove the sulfur plug, you can use special preparations that are sold at pharmacies. They are also used for preventive purposes.
The drops dissolve solid formations and promote their unhindered removal from the ear. The procedure for dissolving the plug is called cerumenolysis. During its implementation, the cork does not increase in size, so the person does not experience any discomfort.
Preparations used to dissolve the cork:
A-cerumen, which can be purchased in dropper bottles. One bottle contains 2 ml of solution. To remove the plug, you need to drop 1 ml of the solution into the ear. After a minute, the passage is cleared. Instillation should be performed once a day for 3-4 days. For prophylactic purposes, the drug is instilled in 1 ml in each passage. The procedure is carried out once every 30 days.
Remo-Wax, which is available in dispenser vials. The volume of one bottle is 10 ml. To remove the plug, 10-20 drops are introduced into each ear canal, wait from 20 minutes to an hour, after which ear hygiene is carried out. The duration of the treatment course is 3-4 days. For preventive purposes, the drug is instilled into the ear 1 time in 14 days.
The drops must be used correctly. First, they need to be warmed to a comfortable temperature. To do this, hold the bottle with the drug in your palms for several minutes. Alternatively, you can warm it up using a water bath. If this is not done, then it can provoke irritation of the inner ear. It houses the vestibular apparatus, which is responsible for the balance of a person. Therefore, the application of the cold solution may cause dizziness, vomiting, and nausea.
To apply drops, the patient is placed on the side opposite the diseased ear. The drug is instilled along the back or along the upper wall of the ear canal, but not in its center. After waiting for the right amount of time, you need to put a napkin to your ear and bend over so that the solution flows out. The procedure should be completed by rinsing the ear with saline.
It is strictly forbidden to use drops if the integrity of the eardrum is compromised, chronic otitis media is diagnosed, or he has suffered purulent otitis media. It is forbidden to use A-cerumen for children under 2 years 6 months.
After the procedure, you must consult an otolaryngologist. The doctor must make sure that the cerumen plug is completely removed from the ear canal.
Video: 5 ways to remove sulfur plug at home:
Hydrogen peroxide to remove sulfur plug
Hydrogen peroxide can be used to remove the sulfur plug. It is important that its concentration does not exceed 3%, otherwise damage to the skin of the ear canal can be called.
After contact with tissues, peroxide begins to break down into oxygen molecules, simultaneously oxidizing the surface exposed to it. Foam is formed, which mechanically cleans the passage, freeing it from the plug. Immediately after the introduction of peroxide and its hit on the cork, hearing will deteriorate. This is normal as the cork will swell and grow in size. After the ear hygiene is done, everything will return to normal.
Before applying peroxide to the ear, it must be brought to a temperature of 37 ° C. Then the patient lies down on the healthy side and introduces 15 drops of peroxide into the passage with a sulfur plug. At this time, he will hear a hiss. In this position, it is necessary to spend 15 minutes, then bend over the napkin and let the liquid flow out. Then the ear is blotted with a cotton swab, but you should not penetrate into the ear canal itself. To completely remove the plug, you need to carry out the procedure at least four times a day. The duration of the course is from 3 to 5 days. After its completion, all symptoms should be stopped.
To make sure that the plug is completely flushed out of the ear, you need to visit an otolaryngologist.
It is forbidden to use hydrogen peroxide if there is a violation of the integrity of the eardrum, or provided that the person has suffered from purulent otitis media. Do not use the drug for chronic otitis media.
Peroxide must be used with caution, as it can burn the tissues of the ear canal. Therefore, if during the procedure a person feels pain or burning sensation, you need to remove the drug from the ear and go to see a doctor.
Ear rinsing to remove wax plug
The ear can only be rinsed in the ENT doctor's office. This procedure is called irrigation. At home, such manipulations should not be performed so as not to damage the integrity of the eardrum.
How is rinsing performed? If the cork is soft, you can wash it right away. Provided that it is solid, then first you need to soften it. To do this, during the day, a person instills hydrogen peroxide of 3% concentration into the ear canal. The procedure must be repeated 5-6 times a day. After 3-4 days, the cork will become soft and can be washed out. Also, pharmacy preparations can be used to soften it.
The ear is washed with saline.
The procedure can be performed using special instruments or devices:
- 100-200 ml of solution is poured into Janet's syringe, which is fed into the ear canal. Under the pressure of the liquid, the particles of the plug come out. The syringe is capable of creating high pressure in the ear (up to 10 atmospheres), and the eardrum can withstand no more than 2 atmospheres. Therefore, a professional should perform the procedure.
- The Proplus irrigator allows you to safely and painlessly remove the plug from the ear canal, as the fluid jet is delivered impulsively and under pressure that can be controlled.
If the patient has a damaged eardrum, the procedure is not performed. It is also prohibited for implementation, provided that the person suffers from chronic otitis media or has suffered purulent otitis media.
Video: ENT doctor about the dangers of cotton swabs:
4 Medical Methods to Remove Wax Plug from the Ear
The doctor can remove the plug from the ear in several ways. The doctor will choose the one that suits the particular patient.
Using Janet's syringe
A rubber tip is put on the tip of Janet's syringe so as not to damage the ear tissue. Then a saline solution warmed up to 37 ° C is poured into it. A person is standing, and on his shoulder is a container for collecting water.
The doctor pulls the ear up and back, and then directs a stream of water from the syringe into the ear canal. It should flow along the upper wall of the auditory opening. The liquid is supplied in jerks. Water flows out of the ear into the tray.
Then the ear is dried using a cotton swab and a turunda soaked in an antiseptic is placed in it for 15 minutes.
During the ear rinsing procedure using an irrigator, the person must be seated. It is covered with a special water-repellent cape, and a container is placed under the ear to collect water.
The doctor pulls the ear back and up, inserts a nozzle into it and delivers an antiseptic solution or water through it by pressing the pedal. The fluid pressure will flush the plug out of the ear canal. The doctor removes its remains with the help of a special spatula, after which he cleans the ear using a napkin. The procedure ends with the removal of fluid from the ear canal. To do this, he uses cotton wool wound on a paddle.
Only soft deposits are removed by vacuum. The procedure is indicated for patients in whom the integrity of the tympanic membrane is impaired. It is also used to remove residual fluid from the ear after rinsing.
The patient sits on a chair. An aspiration tube is inserted into the ear canal, after which the doctor turns on the device. It creates negative pressure which pushes the plug outward.
During the procedure, a person will hear a loud sound, although modern devices do not make much noise.
Also, vacuum aspiration can cause disturbances in the functioning of the vestibular apparatus, which can lead to dizziness, nausea and vomiting. However, if the doctor uses a microscope during the procedure, then the likelihood of developing such side effects is minimal.
Curettage should be performed in those patients who have compromised the integrity of the tympanic membrane, or have had otitis media in the past. It is also prescribed in the case when washing did not allow the desired effect to be achieved, or if the plug consists of particles of the epidermis, which are tightly glued together.
During the procedure, the person must sit. The doctor pulls his ear up and back and inserts special instruments (a spoon, tweezers, or a hook) into it. Under the control of a microscope, he removes the wax plug from the ear.
Then for 20 minutes, cotton wool soaked in an antiseptic or antibiotic is injected into the ear canal.
Devices for removing sulfur plug
As a rule, the otolaryngologist's office has an aspirator and an irrigator.
Description of devices for removing sulfur plug
What is the name of the apparatus
Medical aspirator. It can be stationary and portable.
The equipment of the device includes a container for collecting sulfur plugs, aspiration tubes, a device for creating a vacuum, a power regulator. The device is powered from the mains or from the battery. It also includes a filter that prevents infection from entering the ear.
The irrigator is electronic.
The device is equipped with a compressor or a knob for adjusting, a foot switch for supplying and stopping water, a regulator of pressure and fluid flow, and a hose. The set includes disposable ear tips, scapulas for removing wax, capes for patients so that they do not get clothes wet. The device is powered from the mains or from the battery.
How to prevent the formation of a sulfur plug?
Preventive measures aimed at preventing sulfur plug from forming in the ear canal can be as follows:
- You need to clean the ear canal with a damp cotton swab, without penetrating deep into the canal itself.
- In order for the sulfur to come out better, you need to pull the earlobe down several times every morning.
- If there is such a need, then cotton swabs with a stopper should be used to clean the ear.
- If a person uses a hearing aid or has other risk factors for the formation of a sulfur plug, then for a preventive purpose he needs to use the drug A-cerumen.
- It is necessary to monitor the level of humidity in the room. If it is low, then you should use a humidifier.
- Wear earplugs when working in dusty environments.
- Protect your ears from water ingress. To do this, while swimming, caps are put on the head, or special tampons for bathing are inserted into the ear canals.
- If a person has anatomical features of the structure of the ear canal, then he needs to regularly visit an otolaryngologist and follow his recommendations.
It is important to avoid the following situations to prevent the formation of a sulfur plug:
- Do not insert the ear stick deeply into the ear canal. This will cause the sulfur to compact and form a plug. In addition, there is a risk of damage to the eardrum. You need to take special care of your child's ear canal.
- Do not remove wax from the ear using improvised items such as knitting needles, matches, pins, etc.
- Avoid sudden changes in ambient temperature.
- Do not use ear wax candles. First you need to visit an otolaryngologist. Otherwise, you can only make the situation worse.
Video: Elena Malysheva's program "What's in your ear?":
The author of the article: Lazarev Oleg Vladimirovich | ENT
Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)