=Inspissated Cerumen=, or hardened ear wax is one of the most common
affections of the meatus. The cause in some cases can be traced to
lesions of the mandible, but in many cases the cause is unknown.
=Treatment.=—Protect the clothing by means of a towel or rubber neck
piece. By means of a soft rubber ear syringe, wash the canal thoroughly
by forcing warm soap solution into it. I prefer concentrated liquid
castile soap (any good soap will do) diluted about one to four in water
as warm as the patient can bear it. The soap solution is contained in a
pus bowl held tightly against the neck under the ear. There is little
danger of using too much force with the soft rubber syringe.
In most cases the hardened cerumen will be dislodged by the syringing
only. If this cannot be done, it may be well to discontinue the
treatment until the following day. The solvent action of the soap
solution will further reduce the hardened mass and it usually can be
removed by syringing the following day. This method is preferable in
many cases because patients dislike the pain which usually accompanies
the use of a curet.
The dull loop curet is the most efficient and safest instrument for
removing hardened cerumen that the syringe may fail to dislodge. This
instrument must be used with great care because the membranes, long
protected by the covering of cerumen are hypersensitive and bleed
easily.
After removing the cerumen, the canal should be thoroughly dried and
lubricated with some non-irritating lubricant. It is also well to
place a small pledget of absorbent cotton into the external opening to
protect the sensitive membranes from the cold, air and dust.
In drying the canal I prefer to use a small aluminum applicator,
twisting a small piece of absorbent cotton on the end in such a way as
to cover the tip well, thus making any injury from its use impossible.