DOI: https://doi.org/10.14710/jkd%20(dmj).v14i4.50611

CERUMENOLYTIC AGENTS FOR CERUMEN IMPACTION TREATMENT: A SCOPING REVIEW

*Arsyada Hakama Syakuro  -  Undergraduate Student, Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia, Indonesia
Asti Widuri  -  Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia, Indonesia
Rizka Fakhriani  -  Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia, Indonesia
Deoni Daniswara  -  Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia, Indonesia
Open Access Copyright 2025 Arsyada Hakama Syakuro, Asti Widuri, Rizka Fakhriani, Deoni Daniswara
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Abstract

Background: Cerumen impaction is a common condition all over the world. It is observed in around 5% of adults and has a higher prevalence in children, the elderly, and people with intellectual impairment. The management of cerumen impaction must be treated by general practitioners regarding insurance policies in Indonesia. Besides cerumen removal, in difficult cases for cerumen extraction, we can use cerumenolytic agents. Objective: This scoping review is to identify the current data on cerumenolytic drugs, emphasizing their effectiveness, safety profiles, and optimal treatment practices. Methods: Electronic databases were searched for medicinal treatment of cerumen impaction. The search technique entailed querying three esteemed databases—PubMed, SCOPUS, and ScienceDirect—utilizing the following search terms: (cerumen impaction) OR (cerumen prop) OR (cerumen obturans) OR (earwax) AND (cerumenolytic agent). Results: Ex vivo and in vitro studies demonstrated that carbamide peroxide had significantly more rapid cerumen degradation than phenol glycerol, distilled water was superior to commercial agents, and sodium bicarbonate surpassed docusate sodium, and potassium hydroxide had the quickest disintegration among the agents studied. In vivo investigations validated these patterns, with glycerin-hydrogen peroxide attaining the highest rates of tympanic membrane visualization and sodium bicarbonate demonstrating comparable efficacy to docusate sodium. Conclusion: Sodium bicarbonate was the most evaluated cerumenolytic agent, followed by docusate sodium and distilled water. There was no significant difference in weight growth or disintegration between sodium bicarbonate and docusate sodium, while wet cerumen exhibited a more rapid response than dry cerumen.

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Keywords: (Cerumen, cerumenolytics agents, general practitioners, sodium bicarbonate)

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Section: Original Articles
Language : EN
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  3. Meyer F, Preuß R, Angelow A, Chenot JF, Meyer E, Kiel S. Cerumen Impaction Removal in General Practices: A Comparison of Approved Standard Products. J Prim Care Community Health. 2020;11
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  5. Michaudet C, Malaty J. Cerumen Impaction: Diagnosis and Management [Internet]. Vol. 98. 2018. Available from: www.aafp.org/afp
  6. Justin Sevy AO, Hohman MH, Singh Affiliations A. Cerumen Impaction Removal Continuing Education Activity. 2023
  7. Schumann JA, Toscano ML, Affiliations NP. StatPearls [Internet]. 2022 [cited 2025 Mar 1]. Ear Irrigation. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459335/
  8. Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice. 2005 Feb;8(1):19–32
  9. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Vol. 169, Annals of Internal Medicine. American College of Physicians; 2018. p. 467–73
  10. Asgari A, Asgari HR, Ghorbanlou M, Dobakhti F, Ghorbanian MA. Cerumenolytic Effects of Carbamide Peroxide in Patients with Ear Wax Obstruction. Iran J Otorhinolaryngol. 2024 Mar 1;36(2):415–20
  11. Tynan T, Griffin A, Whitfield BCS. An ex vivo comparison of over-the-counter cerumenolytics for ear wax. Vol. 3, Australian Journal of Otolaryngology. AME Publishing Company; 2020
  12. Srisukhumchai C, Kasemsiri P, Rattanaanekchai T, Srirompotong S, Yordpratum U, Sakolsinsiri C. A comparative in vitro study on the cerumenolytic effect of docusate sodium versus 2.5% sodium bicarbonate using UV–visible absorption spectroscopy. J Otol. 2020 Sep 1;15(3):99–102
  13. Anh NQ, Numthavaj P, Bhongmakapat T. Comparison of the Cerumenolytic Activities of New and Currently Used Agents. Ear Nose Throat J. 2022 Feb 1;101(2):31S-36S
  14. Chongkolwatana C, Sureepong P, Chansomboon K, Kasemsuk N, Srisawat C. In vitro comparison of cerumenolytic efficacy: 2.5 % sodium bicarbonate versus 0.5 % sodium docusate based on cerumen weight gain. American Journal of Otolaryngology - Head and Neck Medicine and Surgery. 2025 Mar 1;46(2)
  15. Soy FK, Ozbay C, Kulduk E, Dundar R, Yazici H, Sakarya EU. A new approach for cerumenolytic treatment in children: In vivo and in vitro study. Int J Pediatr Otorhinolaryngol. 2015 Jul 1;79(7):1096–100
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  17. Fullington D, Song J, Gilles A, Guo X, Hua W, Anderson CE, et al. Evaluation of the safety and efficacy of a novel product for the removal of impacted human cerumen. BMC Ear Nose Throat Disord. 2017 Jun 2;17(1)
  18. Ahmed S. Association of Dermatological Conditions of External Ear with the Use of Cotton Buds. Journal of Enam Medical College. 2014;
  19. Clegg AJ, Loveman E, Gospodarevskaya E, Harris P, Bird A, Bryant J, et al. The safety and effectiveness of different methods of earwax removal: A systematic review and economic evaluation. Health Technol Assess (Rockv). 2010;14(28)
  20. Adegbiji W, Alabi B, Olajuyin O, Nwawolo C. Earwax impaction: Symptoms, predisposing factors and perception among Nigerians. J Family Med Prim Care. 2014;3(4):379
  21. Horton GA, Simpson MTW, Beyea MM, Beyea JA. Cerumen Management: An Updated Clinical Review and Evidence-Based Approach for Primary Care Physicians. Vol. 11, Journal of Primary Care and Community Health. SAGE Publications Inc.; 2020
  22. Manchaiah V, Arthur J, Williams H. Does hearing aid use increase the likelihood of cerumen impaction? Korean J Audiol. 2015;19(3):168–71
  23. Sridharan K, Sivaramakrishnan G. Cerumenolytics with or without manual extraction for impacted earwax: A network meta-analysis of randomised clinical trials. Vol. 46, Clinical Otolaryngology. Blackwell Publishing Ltd; 2021. p. 464–73
  24. Sugiura S, Yasue M, Sakurai T, Sumigaki C, Uchida Y, Nakashima T, et al. Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment. Geriatr Gerontol Int. 2014;14(SUPPL2):56–61
  25. Yang EL, Macy TM, Wang KH, Durr ML. Economic and demographic characteristics of cerumen extraction claims to medicare. JAMA Otolaryngol Head Neck Surg. 2016 Feb 1;142(2):157–61

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