Additional Details:

This comprehensive presentation by Dr. Rita Chaiken and Dr. Jiovanne Hughart offers a detailed overview of cerumen (earwax) and foreign body removal from the external auditory canal, emphasizing anatomical understanding, proper technique, and risk management. Key anatomical structures such as the isthmus, fissures of Santorini, and the proximity to the parotid gland are reviewed for their clinical relevance, particularly regarding infection control. The sensitivity of various canal walls, innervation by cranial nerves (V, VII, IX, X), and potential reflexes (e.g., Arnold’s reflex) are highlighted as essential considerations when performing procedures.

Three primary removal methods are detailed: instrumentation (using curettes, forceps, hooks), suction (various angled tubes and lumen sizes), and irrigation (noting proper temperature and contraindications). The presenters strongly advise against using ear candling and caution about contraindications such as recent surgery, tinnitus, hyperacusis, and systemic conditions like diabetes or cardiac issues. Special emphasis is placed on patient history, medication review, and otoscopic examination before any procedure.

Lighting and magnification tools—like otoscopes, microscopes, and head-worn loops—are deemed critical for safe practice. Recognizing signs of trauma or infection, knowing when to stop a procedure, and maintaining open communication with the patient are vital for minimizing harm. The presentation also covers emergency handling (e.g., bleeding, hematomas) and the use of astringents and topical treatments like vinegar or antibiotic creams. Special guidance is given for pediatric cases and for managing specific foreign bodies such as bugs, domes, and batteries, where creative yet cautious approaches (e.g., using magnets) may be necessary.

Throughout, the instructors underscore the importance of professional liability insurance, informed consent, documentation, and referral readiness. Infection control protocols—including proper glove use, instrument sterilization, and environmental cleanliness—are repeatedly stressed to ensure patient and practitioner safety. The core message is to adhere to training, recognize personal limits, and always prioritize patient wellbeing.

Additional Resources:

• Obtain CE Credit