Ear Wax naturally migrates from the middle aspect of the canal outward.

• Like a good stove, the ear is “self-cleaning.”
• Movement of the jaw assists with the nature migration outward.
• So, anything that interferes with this process can lead to impaction.
  • Anatomic anomalies (ex, stenotic ear canals seen with Down’s Syndrome)
  • Excess cerumen production
  • Ear Plugs
  • Cotton-Tip Applicators
    • Commonly associated with ear wax impaction [Macknin, 1994]
    • Do more harm by pushing ear wax deeper and leaving cotton fibers behind.
    • Good to reinforce avoiding the use of these, or any objects, to insert into the ear canal.
  • Foreign Bodies
  • Hearing Aids