Invited Article Plain Language Summary: Earwax (Cerumen Impaction) Otolaryngology– Head and Neck Surgery 2017, Vol. 156(1) 30–37 Ó American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599816680327 http://otojournal.org Helene J. Krouse, PhD, RN 1 , Anthony E. Magit, MD, MPH 2 , Sarah O’Connor 3 , Seth R. Schwarz, MD, MPH 4 , and Sandra A. Walsh 5 Sponsorships or competing interests that may be relevant to content are dis- closed at the end of this article. Abstract This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that sup- ports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care pro- viders for managing earwax impaction by creating clear rec- ommendations to use in medical practice. Keywords cerumen, earwax, impaction, plain language summary Received October 24, 2016; accepted November 1, 2016. How Was This Summary Developed? This plain language summary is based on the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s (AAO-HNSF’s) ‘‘Clinical Practice Guideline (Update): Earwax (Cerumen Impaction),’’ 1 which updates an earlier guideline developed in 2008 by the AAO-HNSF. 2 The purpose of the summary is to convey key concepts and recommendations from the guideline in clear, understand- able, patient-friendly language. It was developed by consu- mers, clinicians, and AAO-HNS staff. The earwax impaction guideline was developed using the methods outlined in the AAO-HNSF’s ‘‘Guideline Development Manual, Third Edition.’’ 3 A literature search was performed by an information specialist to identify research studies (systematic reviews, clinical practice guidelines, and randomized controlled trials) published since the prior guideline (October 2007 to April 2015). The AAO-HNSF assembled a guideline update group repre- senting the disciplines of otolaryngology–head and neck surgery, otology/neurotology, family medicine, audiology, advanced practice nursing, and a consumer advocate. The group also included a staff member from the AAO-HNSF. Prior to publica- tion, the guideline underwent extensive peer review, including open public comment. Why Do I Have Earwax? Earwax or ‘‘cerumen’’ (si-ROO-men) is a normal substance made by our bodies to clean, protect, and ‘‘oil’’ our ears. It acts as a self-cleaning agent to keep our ears healthy. Dirt, dust, and other small pieces of stuff stick to the earwax which keeps it from getting farther into the ear. Chewing, jaw motion, and growing skin in the ear canal help to move old earwax from inside our ears to the ear opening, where it then flakes off or is washed off when we bathe. This normal pro- cess of making wax and pushing the old wax out continues nonstop. Figure 1 shows where earwax occurs in the ear. 4 What Does It Mean if My Earwax Is Impacted? At times, your ear’s self-cleaning process might not work very well and may lead to a buildup of earwax. When this happens, earwax can collect and block or partly block your ear canal. This is impaction. Impacted earwax can cause symptoms like hearing loss, itching, or ear pain. The impac- tion also makes it hard for your health care provider to see in your ears. You can have symptoms when your ear canal is completely blocked by earwax or only partly blocked. What Are the Symptoms of Earwax Impaction?  Ear pain  Itching 1 College of Nursing, Wayne State University, Detroit, Michigan, USA 2 Division of Otolaryngology, Childrens Hospital of San Diego, San Diego, California, USA 3 AAO-HNS, Alexandria, Virginia, USA 4 Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA 5 Consumers United for Evidence-Based Healthcare, Davis, California, USA Corresponding Author: Sarah O’Connor, Senior Manager, Research & Quality, AAO-HNSF, 1650 Diagonal Rd, Alexandria, VA 22314, USA. Email: soconnor@entnet.org