Abstract：
Cerumen lubricates and protects the external auditory canal, but excess accumulation can lead to ear fullness, itching, otalgia, discharge, hearing loss, and tinnitus. Cerumen should be treated whenever symptoms are present or if it limits diagnosis by preventing a needed otoscopic examination. Clinicians should evaluate for cerumen impaction in those using hearing aids and patients with intellectual disability. Cerumen impaction can be treated with cerumenolytics, ear irrigation, and manual removal with instrumentation. Aural foreign bodies can cause ear fullness, otalgia, discharge, and hearing loss. They are more common in children than adults. The most common type of aural foreign bodies in children is jewelry, followed by paper products, parts of pens or pencils, desk supplies (eg, erasers), BBs or pellets, and earplugs or earphones. In adults, the most common aural foreign bodies are cotton swabs or cotton, followed by hearing aid parts and jewelry or ear accessories. Patients should avoid using cotton tip applicators in the external auditory canal. Alligator forceps, small right angle hooks, and ear irrigation commonly are used to remove aural foreign bodies in an outpatient clinic setting, but the choice depends on the type of foreign body. Soft and irregularly shaped objects can be removed without referral to an otolaryngologist. Patients with hard, spherical, or cylindrical objects should be referred to an otolaryngologist if previous removal attempts have failed or if there is ear trauma to avoid worsening its position in the ear canal.
摘要：
耳垢润滑和保护外耳道，但是过度的积累会导致耳朵丰满，瘙痒,耳痛,放电,听力损失,还有耳鸣.当出现症状或通过防止必要的耳镜检查限制诊断时，应治疗耳垢。临床医生应评估使用助听器和智力障碍患者的耳垢嵌塞。cerumen嵌塞可以用cerumenolitics治疗，耳朵灌溉,和手动删除与仪表。耳异物会导致耳朵充盈，耳痛,放电,和听力损失。它们在儿童中比在成人中更常见。儿童最常见的听觉异物类型是珠宝，其次是纸制品，钢笔或铅笔的一部分，桌面用品(如，橡皮擦)，BB或颗粒，和耳塞或耳机。在成年人中,最常见的听觉异物是棉签或棉花，其次是助听器部件和珠宝或耳朵配件。患者应避免在外耳道使用棉头涂抹器。鳄鱼钳,小直角钩，耳部冲洗通常用于在门诊诊所环境中去除听觉异物，但是选择取决于异物的类型。柔软和不规则形状的物体可以在不转诊耳鼻喉科医生的情况下被移除。患者硬，球形,如果先前的移除尝试失败或有耳部外伤以避免其在耳道中的位置恶化，则应将其转诊给耳鼻喉科医师。
