Big Ear Wax Removal! Extreme Extractions!
Description
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Cerumen is found in the external auditory canal (EAC), which begins at the meatus of the auricle and ends at the tympanic membrane (figure 1) [7]. The lateral one-third of the EAC (cartilaginous EAC) consists of hair and glandular-bearing skin on top of fibrocartilaginous tissue. The sebaceous and ceruminous glands within the skin appendages found in the cartilaginous EAC are responsible for the components of cerumen. The medial two-thirds of the EAC (bony EAC) consist of thin skin adherent to the periosteum of the temporal bone. The canal narrows in most individuals at the isthmus, which is located at the junction of the bony and fibrocartilaginous portions of the canal [8]. Cerumen trapped medial to the isthmus tends to become impacted and cause hearing loss.
At the most medial end of the external canal is the tympanic membrane. The lateral layer of the tympanic membrane consists of keratinizing squamous epithelium that is in continuity with the epithelium of the external canal [9,10]. Lateral epithelial migration allows for removal of sloughing squamous epithelial cells. Further description of the ear canal and discussion of its relationship to external ear canal disease are presented elsewhere. (See "External otitis: Pathogenesis, clinical features, and diagnosis", section on 'Anatomy' and "External otitis: Pathogenesis, clinical features, and diagnosis", section on 'Pathogenesis and risk factors'.)
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