Earwax 425379 226113990 2008-07-16T21:47:37Z BOT-Superzerocool 338065 robot Adding: [[hr:Cerumen]], [[tr:Cerumen]] [[Image:Earwax on swab.jpg|right|thumb|200px|Wet-type human earwax on a [[cotton swab]]. In general, removal of earwax with such swabs is not advised.]] '''Earwax''', also known by the [[medical]] term '''cerumen''', is a yellowish, waxy substance secreted in the [[ear canal]] of [[human]]s and many other [[mammal]]s. It plays an important role in the human ear canal, assisting in cleaning and lubrication, and also provides some protection from [[bacterium|bacteria]], [[fungus|fungi]], and [[insect]]s. Excess or impacted cerumen can press against the eardrum and/or occlude the external auditory canal and impair hearing. ==Production, composition, and different types== [[Image:Dry earwax.jpg|thumb|Dry-type human earwax]] Cerumen is produced in the outer third of the [[cartilage|cartilaginous]] portion of the human ear canal. It is a mixture of [[viscous]] [[secretion]]s from [[sebaceous gland]]s and less-viscous ones from modified [[apocrine sweat glands]].<ref name=Alvord>{{ cite journal | author= Alvord, L.S., Farmer, B.L. | title='''Anatomy and orientation of the human external ear''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=383-390 | volume=8 | issue=6 | pmid=9433684 }}</ref> The primary components of earwax are the final products in the [[HMG-CoA reductase pathway]], namely, [[squalene]], [[lanosterol]], and [[cholesterol]]. There are two distinct [[genetics|genetically]] determined types of earwax: the wet type, which is [[dominant gene|dominant]], and the dry type, which is [[recessive gene|recessive]]. [[Asian people|Asian]]s and [[Native Americans in the United States|Native Americans]] are more likely to have the dry type of cerumen (grey and flaky), whereas [[white (people)|Caucasian]]s and [[African]]s are more likely to have the wet type (honey-brown to dark-brown and moist).<ref name=Overfield>{{ cite book | author = Overfield, T. | title = '''Biologic Variation in Health and Illness: Race, Age, and Sex Differences''' | year = 1985 | publisher = Addison-Wesley Publishing | location = Menlo Park, CA, USA | id = ISBN 0-201-12810-1 }}</ref> Cerumen type has been used by [[anthropology|anthropologists]] to track human migratory patterns, such as those of the [[Inuit]].<ref name=Bass>{{ cite journal | author= Bass, E.J., Jackson, J.F. | title='''Cerumen types in Eskimos''' | journal=Am.J.Phys.Anthropol. | year=1977 | pages=209&ndash;210 | volume=47 | issue=2 | pmid=910884 }}</ref> The difference in cerumen type has been tracked to a single [[base pair|base]] change (a [[single nucleotide polymorphism]]) in a gene known as "[[ATP-binding cassette transporter genes|ATP-binding cassette]] C11 gene."<ref>{{OMIM|117800}}</ref> In addition to affecting cerumen type, this mutation also reduces [[sweating|sweat]] production. The researchers conjecture that the reduction in sweat was beneficial to the ancestors of East Asians and Native Americans who are thought to have lived in cold climates.<ref name=Yoshiura>{{ cite journal | author= Yoshiura, K.I., ''et al.'' | title='''A SNP in the ABCC11 gene is the determinant of human earwax type''' | journal=Nat Genet. | year=2006 | date=29 January 2006 | url=http://www.nature.com/ng/journal/v38/n3/full/ng1733.html | pmid=16444273 | doi= 10.1038/ng1733 }}</ref> ==Function== [[Image:Earwax on swab (uv).jpg|right|thumb|200px|Wet-type earwax fluoresces weakly under [[ultraviolet]] light.]] === Cleaning === Cleaning of the ear canal occurs as a result of the "conveyor belt" process of [[epithelium|epithelial]] migration, aided by [[jaw]] movement.<ref name=Alberti>{{ cite journal | author= Alberti, P.W.R.M. | title='''Epithelial migration on the tympanic membrane''' | journal=J.Laryngol.Otol. | year=1964 | pages=808-830 | volume=78 | pmid=14205963 }}</ref> Cells formed in the centre of the [[Ear drum|tympanic membrane]] migrate outwards from the [[Umbo of tympanic membrane|umbo]] (at a rate equivalent to that of fingernail growth) to the walls of the ear canal, and accelerate towards the entrance of the ear canal. The cerumen in the canal is also carried outwards, taking with it any dirt, dust, and particulate matter that may have gathered in the canal. Jaw movement assists this process by dislodging debris attached to the walls of the ear canal, increasing the likelihood of its expulsion. === Lubrication === Lubrication prevents [[desiccation]], itching, and burning of the [[skin]] within the ear canal (known as ''asteatosis''). The lubricative properties arise from the high [[lipid]] content of the sebum produced by the sebaceous glands. In wet-type cerumen at least, these lipids include [[cholesterol]], [[squalene]], and many long-chain [[fatty acid]]s and [[alcohol]]s.<ref name=Harvey>{{ cite journal | author= Harvey, D.J. | title='''Identification of long-chain fatty acids and alcohols from human cerumen by the use of picolinyl and nicotinate esters''' | journal=Biomed.Environ.Mass.Spectrom. | year=1989 | pages=719-723 | volume=18 | issue=9 | pmid=2790258 }}</ref><ref name=Bortz>{{ cite journal | author= Bortz, J.T., Wertz, P.W., Downing, D.T. | title='''Composition of cerumen lipids''' | journal=J.Am.Acad.Dermatol. | year=1990 | pages=845-849 | volume=23 | issue=5 | pmid=2254469 }}</ref> === Antibacterial and antifungal roles === While studies conducted up until the 1960s found little evidence supporting an antibacterial role for cerumen,<ref name=Perry>{{ cite journal | author= Perry, E.T., Nichols, A.C. | title='''Studies on the growth of bacteria in the human ear canal''' | journal=J.Invest.Dermatol. | year=1956 | pages=165&ndash;170 | volume=27 | issue=3 | pmid=13367525 }}</ref> more recent studies have found that cerumen has a bactericidal effect on some strains of bacteria. Cerumen has been found to be effective in reducing the viability of a wide range of bacteria (sometimes by up to 99%), including ''[[Haemophilus influenzae]]'', ''[[Staphylococcus aureus]]'', and many variants of ''[[Escherichia coli]]''.<ref name=Chai>{{ cite journal | author= Chai TJ, Chai TC. | title='''Bactericidal activity of cerumen''' | journal=Antimicrob Agents Chemother. | year=1980 | pages=638-641| volume=18 | issue=4 | url=http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=7447422 | pmid=7447422 }}</ref><ref name=Stone>{{ cite journal | author= Stone, M., Fulghum, R.S. | title='''Bactericidal activity of wet cerumen''' | journal=Ann Otol Rhinol Laryngol. | year=1984 | pages=183&ndash;186 | volume=93 | issue=2 | pmid=6370076 }}</ref> The growth of two [[fungus|fungi]] commonly present in [[otomycosis]] was also significantly inhibited by human cerumen.<ref name=Megarry>{{ cite journal | author= Megarry, S., Pett, A., Scarlett, A., Teh, W., Zeigler, E., Canter, R.J. | title='''The activity against yeasts of human cerumen''' | journal=J.Laryngol.Otol. | year=1988 | pages=671-672 | volume=102 | issue=8 | pmid=3047287 }}</ref> These antimicrobial properties are due principally to the presence of [[saturation (chemistry)|saturated]] fatty acids, [[lysozyme]] and, especially, to the relatively low [[pH]] of cerumen (typically around 6.1 in normal individuals<ref name=Roland>{{ cite journal | author= Roland, P.S., Marple, B.F. | title='''Disorders of the external auditory canal''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=367&ndash;378 | volume=8 | issue=6 | pmid=9433682 }}</ref>). ==Removal== <!--Earwax removal redirects here--> Excessive cerumen may impede the passage of [[sound]] in the ear canal, causing [[conductive hearing loss]]. It is also estimated to be the cause of 60–80% of [[hearing aid]] faults.<ref name=Oliveira>{{ cite journal | author= Oliveira, R.J. | title='''The active earcanal''' | journal=J Am Acad Audiol. | year=1997 | pages=401-410 | volume=8 | issue=6 | pmid=9433686 }}</ref> As mentioned above, movement of the jaw helps the ears' natural cleaning process, so [[chewing gum]] and talking can both help. If this is not sufficient, the most common method of cerumen removal by [[general practitioner]]s is [[syringe|syringing]] with warm water (used by 95% of GPs<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref>). A [[curette]] method is more likely to be used by [[Otolaryngology|otolaryngologists]] when the ear canal is partially occluded and the material is not adhering to the skin of the ear canal. [[Cotton swab]]s, on the other hand, push most of the earwax further into the ear canal and remove only a small portion of the top layer of wax that happens to adhere to the fibers of the swab. The term "cerumenectomy" is occasionally used to describe the removal of cerumen. ===Cerumenolysis=== In cases of those who have the "wet-type" of earwax, it is usually necessary to soften wax before its removal. This process is referred to as ''cerumenolysis'', and is achieved using a solution known as a cerumenolytic agent which is introduced into the ear canal. The most common home-remedy for this purpose is olive oil.<ref name=Fraser>{{ cite journal | author= Fraser J.G. | title='''The efficacy of wax solvents, in vitro studies and clinical trial''' | journal=J.Laryngol.Otol. | year=1970 | pages=1055-1064 | volume=84 | issue=10 | pmid=5476901 }}</ref> Other commercially available and common cerumenolytics include: * [under multiple brand names] [[Carbamide peroxide]] (6.5%) and [[glycerine]] * [[Sodium bicarbonate]] B.P.C. (sodium bicarbonate and glycerine) * Various [[Organic compound|organic]] liquids ([[glycerol]], [[almond oil]], [[mineral oil]], [[baby oil]]) * Cerumol ([[arachis oil]], [[turpentine]] and [[1,2-Dichlorobenzene|dichlorobenzene]]) * Cerumenex ([[Triethanolamine]], [[polypeptide]]s and [[oleic acid|oleate-condensate]]) * Exterol, Otex (UK brand name) ([[urea]], [[hydrogen peroxide]] and glycerine) * [[Docusate]], a detergent, an [[active ingredient]] found in [[laxative]]s A cerumenolytic should be used 2-3 times daily for 3-5&nbsp;days prior to the cerumen extraction.<ref name=Wilson>{{ cite journal | author= Wilson, P.L., Roeser, R.J. | title='''Cerumen management: professional issues and techniques''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=421-430 | volume=8 | issue=6 | pmid=9433688 }}</ref> Although most commercially available cerumenolytics available in the U.S. are identical, containing carbamide peroxide (6.5%) and glycerine,<ref name=Wilson>{{ cite journal | author= Wilson, P.L., Roeser, R.J. | title='''Cerumen management: professional issues and techniques''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=421-430 | volume=8 | issue=6 | pmid=9433688 }}</ref> a 10% solution of [[sodium bicarbonate]] (baking soda) was found to be a more effective cerumenolytic than several commercially-available solutions (Cerumenex, Auralgan) and numerous organic liquids, including [[glycerine]], [[olive oil]], and [[alcohol]].<ref name=Robinson>{{ cite journal | author= Robinson, A.C., Hawke, M. | title='''The efficacy of ceruminolytics: everything old is new again''' | journal=J.Otolaryngol. | year=1989 | pages=263&ndash;267 | volume=18 | issue=6 | pmid=2555535 }}</ref> Additionally, 1 mL of [[docusate]] was also found to be a more effective cerumenolytic than several commercially-available solutions (Cerumenex, Debrox).<ref>[http://www.globalrph.com/docusate.htm How effective is docusate as a cerumenolytic agent?<!-- Bot generated title -->]</ref> Docusate may be extracted from liquid preparations of laxatives, such as Colace. A systematic review of studies of the effectiveness of topical preparations for the treatment of earwax<ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1324923 The effectiveness of topical preparations for the treatment of earwax: a systematic review<!-- Bot generated title -->]</ref> concluded that cerumenolysis is better than no treatment, but there is little to choose between oil- and water-based preparations (including plain water). Applying such a preparation half an hour before syringing is probably as effective as applying it for several days. Several days' treatment with some preparations not based on water or oil appears promising. More studies are needed. ===Syringing=== Once the cerumen has been softened, it may be removed from the ear canal by irrigation. Ear syringing techniques are described in great detail by Wilson & Roeser,<ref name=Wilson>{{ cite journal | author= Wilson, P.L., Roeser, R.J. | title='''Cerumen management: professional issues and techniques''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=421-430 | volume=8 | issue=6 | pmid=9433688 }}</ref> and Blake et al.,<ref name=Blake>{{ cite journal | author= Blake, P., Matthews, R., Hornibrook, J. | title='''When not to syringe an ear''' | journal=N.Z.Med.J. | year=1998 | pages=422-424 | volume=111 | issue=1077 | pmid=9861921 }}</ref> who advise pulling the external ear up and back, and aiming the nozzle of the syringe slightly upwards and backwards so that the water flows as a cascade along the roof of the canal. The irrigation solution flows out of the canal along its floor, taking wax and debris with it. The solution used to irrigate the ear canal is usually warm water,<ref name=Blake>{{ cite journal | author= Blake, P., Matthews, R., Hornibrook, J. | title='''When not to syringe an ear''' | journal=N.Z.Med.J. | year=1998 | pages=422-424 | volume=111 | issue=1077 | pmid=9861921 }}</ref> normal [[Saline (medicine)|saline]],<ref name=Ernst>{{ cite journal | author= Ernst, A.A., Takakuwa, K.M., Letner, C., Weiss, S.J. | title='''Warmed versus room temperature saline solution for ear irrigation: a randomised clinical trial''' | journal=Ann.Emerg.Med. | year=1999 | pages=347&ndash;350 | volume=34 | issue=3 | pmid=10459091 }}</ref> sodium bicarbonate solution,<ref name=Bull>{{cite book | last = Bull | first = P.D. | title = '''Lecture notes on diseases of the ear nose and throat''' | edition = 6th edition | year = 1985 | publisher = Blackwell Scientific Publications | location = Oxford | id = ISBN 0-632-06506-0 }}</ref> or a solution of water and [[vinegar]] to help prevent secondary infection.<ref name=Blake>{{ cite journal | author= Blake, P., Matthews, R., Hornibrook, J. | title='''When not to syringe an ear''' | journal=N.Z.Med.J. | year=1998 | pages=422-424 | volume=111 | issue=1077 | pmid=9861921 }}</ref> Patients generally prefer the irrigation solution to be warmed to body temperature,<ref name=Ernst>{{ cite journal | author= Ernst, A.A., Takakuwa, K.M., Letner, C., Weiss, S.J. | title='''Warmed versus room temperature saline solution for ear irrigation: a randomised clinical trial''' | journal=Ann.Emerg.Med. | year=1999 | pages=347&ndash;350 | volume=34 | issue=3 | pmid=10459091 }}</ref> as [[dizziness]] is a common side effect of syringing with fluids that are colder or warmer than body temperature. Sharp et al.<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref> recommend 37 °C, while Blake et al.<ref name=Blake>{{ cite journal | author= Blake, P., Matthews, R., Hornibrook, J. | title='''When not to syringe an ear''' | journal=N.Z.Med.J. | year=1998 | pages=422-424 | volume=111 | issue=1077 | pmid=9861921 }}</ref> recommend using water at 38 °C, one degree above body temperature, and stress that this should be checked with a thermometer. Any other temperature may cause [[Vertigo (medical)|vertigo]], just as used when testing the [[caloric reflex test]]. A syringe should be used to gently stream water into the ear. For children the rate and speed should be lower. After irrigating, the head is tipped to allow the water to drain. Irrigation may need to be repeated several times. If the water stream hurts then the flow should be slower. It is better to irrigate too gently for a long period than irrigate too forcefully attempting to remove wax quickly. This procedure can be done at home in the shower using a self-use ear irrigation syringe with a right angle tip. After the wax is removed, the ear can be dried by tipping the head and gently pulling the ear upwards to straighten the ear canal. ===Curette method=== The earwax is removed through the use of an [[ear pick]], which physically dislodges the earwax and scoops it out of the ear canal. In the west, use of a curette or ear pick is often only done in the hands of health professionals; a modified curette having a safety stop to prevent deep insertion for self-use is available. Curetting earwax using an ear pick is common in [[East Asia]]. As the earwax of most East Asians is of the dry type,<ref name=Overfield>{{ cite book | author = Overfield, T. | title = '''Biologic Variation in Health and Illness: Race, Age, and Sex Differences''' | year = 1985 | publisher = Addison-Wesley Publishing | location = Menlo Park, CA, USA | id = ISBN 0-201-12810-1 }}</ref> it is extremely easy to remove all earwax via light scraping with an ear pick as it simply falls out in large pieces or dry flakes, often on its own. ===Hazards=== A postal survey of British general practitioners<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref> found that only 19% always performed the procedure themselves; many delegated the task to practice nurses, some of whom had received no instruction. This is problematic as the removal of cerumen is not without risk. Irrigation can be performed at home with proper equipment as long as the person is careful not to irrigate too hard. All other methods should only be carried out by individuals who have been sufficiently trained in the procedure. Bull advised physicians: ''"After removal of wax, inspect thoroughly to make sure none remains. This advice might seem superfluous, but is frequently ignored."''<ref name=Bull>{{cite book | last = Bull | first = P.D. | title = '''Lecture notes on diseases of the ear nose and throat''' | edition = 6th edition | year = 1985 | publisher = Blackwell Scientific Publications | location = Oxford | id = ISBN 0-632-06506-0 }}</ref> This was confirmed by Sharp et al.,<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref> who, in a survey of 320 general practitioners, found that only 68% of doctors inspected the ear canal after syringing to check that the wax was removed. As a result, failure to remove the wax from the canal made up approximately 30% of the complications associated with the procedure. Other complications included [[otitis externa]], [[pain]], [[Vertigo (medical)|vertigo]], [[tinnitus]], and perforation of the ear drum. Based on this (single) study, a rate of major complications in 1/1000 ears syringed was suggested.<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref> Claims arising from ear syringing mishaps account for about 25% of the total claims received by [[New Zealand]]'s [[Accident Compensation Corporation]] ENT Medical Misadventure Committee.<ref name=Blake>{{ cite journal | author= Blake, P., Matthews, R., Hornibrook, J. | title='''When not to syringe an ear''' | journal=N.Z.Med.J. | year=1998 | pages=422-424 | volume=111 | issue=1077 | pmid=9861921 }}</ref> While high, this is not surprising, as ear syringing is an extremely common procedure. Grossan suggested that approximately 150,000 ears are irrigated each week in the United States, and about 40,000 per week in the United Kingdom.<ref name=Grossan>{{ cite journal | author= Grossan, M. | title='''Cerumen removal – current challenges''' | journal=Ear Nose Throat J. | year=1998 | pages=541-548 | volume=77 | issue=7 | pmid=9693470 }}</ref> Extrapolating from data obtained in Edinburgh, Sharp et al.<ref name=Sharp>{{ cite journal | author= Sharp, J.F., Wilson, J.A., Ross, L., Barr-Hamilton, R.M. | title='''Ear wax removal: A survey of current practice''' | journal=Br.Med.J. | year=1990 | pages=1251-1253 | volume=301 | issue=6763 | pmid=2271824 }}</ref> place this figure much higher, estimating that approximately 7000 ears are syringed per 100,000 population per annum. In the New Zealand claims mentioned above, perforation of the tympanic membrane was by far the most common injury resulting in significant disability. ===Cotton swabs=== It is generally advised not to use [[cotton swab]]s (Q-Tips or cotton buds), as doing so will likely push the wax farther down the ear canal, and if used carelessly, perforate the [[eardrum]]. Abrasion of the ear canal, particularly after water has entered from swimming or bathing, can lead to ear infection. Also, the cotton head may fall off and become lodged in the ear canal. Cotton swabs should be used only to clean the external ear. ===Vacuuming=== Vacuuming of the ear may be done by professionals or by home-vacuum kits. However, a study in ''[[Clinical otolaryngology]]'' found that home "ear vacs" were ineffective at removing ear-wax, especially when compared to a Jobson-Horne probe.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/16209672 A non-randomized comparison of earwax removal with a 'do-it-yourself' ear vacuum kit and a Jobson-Horne probe.] PMID:16209672</ref> ===Ear candling=== {{Main|Ear candling}} [[Ear candling]], a [[folk medicine]] practice, is claimed to remove ear wax and improve ear health. It involves placing a hollow candle in the ear canal and lighting it; the rising hot air is believed to suction out wax and "toxins" from the ear. An earwax-like substance does indeed collect inside the ear candle as it burns - however it collects there even if the candle is placed in a clean, dry drinking glass instead of on an ear. Ear candles are a fringe remedy in North America and Europe, but the claimed benefits are not supported by [[scientific evidence]].<ref name=Carroll>{{cite web | author = Carroll, R.T. | year = 2005 | url = http://www.skepdic.com/coning.html | title = The Skeptic's Dictionary: ear candling (coning) | accessdaymonth = [[13 February]] | accessyear = [[2006]] }}</ref> Ear candles can also drip hot melted candle wax inside a person's ear; if the hot wax lands on the eardrum, it can cause great pain and possible hearing damage.<ref name=Adams>{{cite web | author = Adams, Cecil | year = 1995 | url = http://www.straightdope.com/classics/a5_098.html | title = The Straight Dope: How do "ear candles" work? | accessdaymonth = [[21 March]] | accessyear = [[2006]] }}</ref> Seely, Quigley and Langman reported that, in a survey of 122 ENT physicians, 21 ear injuries were reported due to ear candling.<ref name=Seely>{{ cite journal | author=Seely, D.R., Quigley, S.M., Langman, A.W. | title='''Ear candles - efficacy and safety''' | journal=Laryngoscope | year=1996 | pages=1226-1229 | volume=106 | issue=10 | pmid=8849790 }}</ref> Ernst, in a review of the literature, finds that ear candling has no real effect on earwax removal, and poses a danger of ear injuries. He concludes that ear candling is "a triumph of ignorance over science".<ref name=Ernst2>{{ cite journal | author=Ernst, E. | title='''Ear candles: A triumph of ignorance over science''' | journal=J. Laryngol. Otol.| year=2004 | pages=1&ndash;2 | volume=118 | issue=1 | pmid=14979962 }}</ref> Ear candles also deposit candle wax into the bottom of the ear candle tube, which can be interpreted as ear wax, but is simply brown wax from the candle. ==Earwax in whales== Many species of [[whale]] have an annual buildup of earwax, adding one, two, or four layers (depending upon the species) each year. Similar to the [[incremental dating]] method of [[dendrochronology]] for trees, the number of layers can be counted to determine the age of the whale after its death.<ref>[http://www.cs.ucf.edu/~MidLink/baldrige.jan.two.html Commanding Officer of NOAA Ship MALCOLM BALDRIGE]</ref> ==See also== *[[Ear pick]] *[[List of Mendelian traits in humans]] ==Further reading== A comprehensive review of the [[physiology]] and [[pathophysiology]] of earwax can be found in a 1997 review article by Roeser and Ballachanda.<ref name=Roeser>{{ cite journal | author= Roeser, R.J., Ballachanda, B.B. | title='''Physiology, Pathophysiology, and Anthropology/Epidemiology of Human Earcanal Secretions''' | journal=J.Am.Acad.Audiol. | year=1997 | pages=391-400 | volume=8 | issue=6 | pmid=9433685 }}</ref> See also the New York Times article on the Yoshiura earwax study.<ref name=Wade>{{ cite journal | author= Wade, Nicholas | title='''Japanese Scientists Identify Ear Wax Gene''' | journal=New York Times. | year=2006 | month=January | day=29 }}</ref> ==References== {{reflist|2}} ==External links== *[http://www.deafnessresearch.org.uk/?lid=1902 Looking after your ears] Deafness Research UK *[http://www.patient.co.uk/showdoc/23068727 Ear wax and its treatment] Patient UK *[http://www.medinfo.co.uk/conditions/earwax.html Ear wax and its treatment] Medinfo UK *[http://www.deafnessresearch.org.uk/?lid=1887 Ear wax and its treatment] Deafness Research UK *[http://www.abc.net.au/science/news/stories/s1558166.htm Gooey earwax is in your genes], ABC Science Online, [[30 January]] [[2006]] *Nicholas Wade. [http://www.nytimes.com/2006/01/30/science/30ear.html Scientists Find Gene That Controls Type of Earwax in People]. ''[[The New York Times]]'', [[30 January]] [[2006]] *[http://www.ncbi.nlm.nih.gov/pubmed/6370076?dopt=Abstract Bactericidal activity of wet cerumen (scientific journal article).] *[http://iai.asm.org/cgi/content/full/67/9/4843 Ear canal produces mRNA for beta-defensin-1, a natural antibiotic (scientific journal article).] [[Category:Auditory system]] [[Category:Waxes]] [[Category:Body fluids]] [[ar:شمع الأذن]] [[bn:কানের খোল]] [[ca:Cerumen]] [[da:Ørevoks]] [[de:Ohrenschmalz]] [[es:Cerumen]] [[fr:Cérumen]] [[ko:귀지]] [[hr:Cerumen]] [[it:Cerume]] [[la:Cerumen]] [[lb:Ouereschmalz]] [[nl:Oorsmeer]] [[ja:耳垢]] [[no:Ørevoks]] [[pl:Woskowina]] [[pt:Cerúmen]] [[qu:Rinri wira]] [[ru:Ушная сера]] [[fi:Vaikku]] [[sv:Öronvax]] [[tr:Cerumen]] [[yi:אויער וואקס]] [[zh:耳垢]]