Self-cleaning ability of ears can wane

Dear Dr. Gott: What causes wax buildup in the ears, so much so that it affects hearing? Could a sinus condition be the cause of the problem?

Dear Reader: Everybody manufactures wax (cerumen) in the ear canals. This is nature’s way of protecting the delicate eardrums against injury. But, like many of our protective devices, this may cause problems if the wax becomes stuck (impacted) in the canal, causing loss of hearing. Some people seem to be particularly prone to this annoying but harmless condition, which has nothing whatsoever to do with the sinuses or inner ears.

A twisted canal (that we are born with) or excessive proliferation of hairs in the canal (that we may develop as we age) inhibits the natural expulsion of wax particles. Normally, pieces of wax work their way out of the ear and are washed away. However, in many cases, the wax builds up over the years and will ultimately block the canal, necessitating removal.

This condition can be vastly worsened by using cotton-tipped applicators in the ears. Not only will the applicators push the wax in farther and compact it, these seemingly soft sticks can also rupture the eardrum when inserted too deeply into the canal.

In most instances, earwax can be easily removed by a health professional after it has been lubricated by using oil (the night before) or a wax-softener such as Debrox. Murine now markets a do-it-yourself wax removal kit containing a softener and a bulb syringe.

Also, the regular use of hydrogen peroxide (half a capful in each ear every week or so) may prevent wax impaction. As the peroxide fizzes and foams, it dislodges particles of wax that are carried out by the bubbles.

Dear Dr. Gott: I’m a 67-year-old male and was diagnosed with syringomyelia. If you’ve ever heard of this malady, please provide information on it.

Dear Reader: This neurological disease causes progressive loss of the sensations of pain and touch over the hands, arms and shoulders, in a capelike distribution. Eventually, this leads to weakness of the legs, face and throat. However, the course is variable.

The usual cause of syringomyelia is a congenital fluid-filled structure within the spinal canal that produces these symptoms as it enlarges – ordinarily, for unknown reasons, during adolescence or young adult years. Sometimes these cystlike collections of fluid result from trauma or appear in association with tumors of the spinal cord. The diagnosis is made by CT or MRI scanning.

Surgery to drain or shunt the fluid is often successful but may not prevent or reverse the nerve deterioration.