PubMed · 17066850
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2006-10-06. Cerumen removal.. https://pubmed.ncbi.nlm.nih.gov/17066850/
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Keratosis obturans is characterized by the accumulation of desquamated keratinous material in the bony portion of the external auditory canal. Classically, it is reported to present with severe otalgia, conductive hearing loss and global widening of the external auditory canal. Extensive erosion of the bony meatus, with exposure of the facial nerve, has been previously reported, but no case of facial nerve palsy has as yet been published. We report the first published case, to our knowledge, of a unilateral facial nerve palsy secondary to neglected keratosis obturans.
* Syringing of ears to remove cerumen is losing favour in primary care owing to the fact that it is carried out 'blind' and that the potential exists for serious complications. * Dewaxing under direct vision is difficult without a microscope. * A technique is described where wax is removed under direct vision using a rigid endoscope in conjunction with a Jobson-Horne probe and St Bartholomew's wax hook. * This is a relatively inexpensive technique that could be introduced to primary care practitioners or to ENT surgeons who do not have easy access to an operating microscope in the outpatient department.