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	Dr. Peter Roland, chairman of otolaryngology - head and neck surgery, helped develop new national guidelines regarding the removal of wax from the ear.

In addition, people with hearing aids should be checked for impaction during regular check-ups because cerumen can cause feedback, reduced sound intensity or damage the hearing aid, according to the guidelines.

The guidelines were created with input from family practitioners, pediatricians, internists, nurses, audiologists and emergency room doctors and have been endorsed by the American Academy of Otolaryngology — Head and Neck Surgery.

There are no proven methods for avoiding impaction, according to the analysis, so when should you seek out a professional?

“When cerumen builds to the point of causing symptoms such as pain, ringing, itching or hearing problems, it’s a sign you should see a physician,” said Dr. Roland, who also serves as chief of pediatric otology at Children’s Medical Center Dallas.

The problem affects one in 10 children, one in 20 adults, and greater than one-third of the elderly and cognitively impaired, according to the academy. About 12 million people annually seek treatment for impacted or excessive cerumen, resulting in nearly 8 million cerumen removal procedures by health care professionals.

“Earwax” is not actually wax, but a water-soluble mixture of secretions produced in the outer third of the ear canal, along with hair and dead skin.

The mixture serves a critical protective function for the ear and shouldn’t be removed unless it’s causing symptoms or interfering with assessments of the ear, said Dr. Roland, who heads to Clinical Center for Auditory, Vestibular and Facial Nerve Disorders at UT Southwestern.

“The complications from cerumen impaction can be painful and include infections and hearing loss,” Dr. Roland said. “It is hoped that these guidelines will give clinicians the tools they need to spot an issue early and avoid serious outcomes.”

The guidelines appear in a supplement to the September issue of Otolaryngology – Head and Neck Surgery. They will also be presented at the academy’s September meeting in Chicago.

The new guidelines are based on extensive reviews of scientific studies for a wide range of health care professionals from family doctors and pediatricians, to ear, nose and throat specialists (otolaryngologists).