Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Cerumen (Ear Wax) Impaction

Earwax has numerous protective functions such as trapping dust/debris, serving as a moisture barrier, and killing microorganisms that enter the ear canal. In general, individuals should not attempt to remove the earwax by inserting objects such as cotton swabs, paper clips, or hairpins into the ears. Earwax will most often move out of the ear naturally over time without any assistance. Cerumen impaction occurs when the wax builds up or becomes too hard to exit the ear canal naturally. In some people, earwax is produced at a greater rate than can be naturally removed by the ear. Earwax may also become impacted after the use of cotton swabs and other such instruments that push the wax deeper into the ear canal. Patients who use hearing aids or earplugs regularly also have an increased incidence of cerumen impaction. In general, management options for cerumen impaction include saline irrigations or direct removal under an operating microscope. Once earwax is fully removed, a maintenance regimen of at-home ear irrigations may be required.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care for his patients.
  • Dr. Jacob prefers removing cerumen under direct vision using the operative microscope. He typically uses suction or small, curved curettes. This technique ensures that wax is completely removed and that underlying infections or more complex anatomical problems such as cholesteatoma are not missed. If cerumen impaction occurs frequently, he sometimes recommends use of eardrops or ear irrigations at home to prevent buildup. It is critical that irrigations not be used unless (1) the eardrum is known to be intact and (2) no infections are present in the ear canals.