Paeds Cerumen impaction

Question 1

What are common symptoms of cerumen impaction in children?

Answer 1

Hearing loss, ear fullness, discomfort, otorrhoea (discharge), tinnitus, dizziness, and sometimes cough or otalgia

Question 2

What is the first-line management for cerumen impaction in children?

Answer 2

sodium bicarbonate 5% ear drops, olive oil, or almond oil drops to soften wax for 3–5 days

Question 3

When should ear drops NOT be used for cerumen impaction?

Answer 3

If there is a suspected or known perforation of the tympanic membrane, active ear infection, or grommets in place

Question 4

What advice should be given to parents about ear hygiene?

Answer 4

Do not use cotton buds or other objects to clean inside the ear canal; the ear is usually self-cleaning

Question 5

When should referral to a specialist be considered?

Answer 5

If impaction persists despite primary care management, or if the child has anatomical abnormalities, severe pain, recurrent impaction, or complications