Both TM's obstructed by cerumen.

Tympanogram shows small ear canal volumes.

How would you remove the cerumen?

What advice would you give the parent about taking care of the cerumen in the future?

The presence of cerumen in the ears of infants and young children is a common occurrence that frustrates the caregiver. Cerumen removal can be accomplished by either gentle curettage under direct visualization or by gentle lavage. These techniques are illustrated in the Patient Evaluation section.

The cerumen in this ear appears to be soft and most likely can be cautiously removed with an ear curette. Proper restraint of the child is of utmost importance. Cerumen occurs naturally and has some protective function, so unless it interferes with hearing, parents need not be concerned with removal. As long as the cerumen is soft, it can be removed fairly easily in order to visualize the tympanic membrane.

If the cerumen is hard or flaky, ear wax removal drops, available at the pharmacy without a prescription, given twice a week,  will have a softening effect, making removal by the health care provider easier. Parents should be instructed not to use q-tips or any other objects in the child's ear because they can push the cerumen farther into the canal and there is a risk of trauma to the ear canal and perforation of the TM. Children with a perforated TM should not receive cerumen removal drops.