treatment: frequent removal
* take careful Pt hx to rule out TM perf, ear disease, previous ear surgery, diabetes, AIDS, anticoagulants meds
--> Otoscopic examination
-->preremoval audiometry and immitance (up to 40 dB conductive HL)
Use: suction, wire loop or blunt hook
-irrigation at body temperature (NOT if perf or otitis externa) too warm or too cold=can cause dizziness
-use chemical agents to soften wax.
* Be careful not to force wax in or lacerate EC or TMI
* also if hair in wax can be painful if you remove
* Cough reflex can be elicited in the deep portion of the canal
-->Most reliability exposure to our profession, dangerous in diabetics and/or other people with poor circulation.
ex:Possible ossicular dislocation, TM perf, bleeding etc.