Embarrassing Illnesses

No tests are necessary to confirm the presence of earwax. If you have a history of recurrent earwax problems, it is likely that you will know when you have another build-up of earwax.

If you have problems as a result of a build-up of earwax, your GP or a specialist will examine both of your ear canals with an auriscope. An auriscope, also known as an otoscope, is an instrument that incorporates a light and a lens to enable a doctor to examine the inside of your ear.

Using the auriscope, your GP or specialist can see whether there is earwax inside your ear, and whether or not it appears to be impacted (firmly lodged in your ear canal). If you have hearing loss, it may be the result of impacted earwax.

Detecting hearing loss

Hearing loss can be detected using tuning fork tests, such as the Rinne test and Weber test. These are outlined below.

Rinne test

The Rinne test involves placing a vibrating tuning fork at different points on your ear to test your hearing.

The tuning fork is held close to the entrance of the ear canal (external auditory meatus), then it is held behind the ear lobe (mastoid bone).

Normally, the ear picks up sound through the external auditory canal and middle ear (air conduction), rather than through the skull (bone conduction). If the sound of the tuning fork is louder when it is held against your mastoid bone, there may be a problem with your external auditory canal or middle ear.

Weber test

During a Weber test, a vibrating tuning fork is placed on the middle of your forehead. As with the Rinne test, the Weber test enables the tester to determine whether your hearing loss is sensorineural (sound loss through the air), conductive (sound loss through bone), or whether it is a combination of both.

Overall, tuning fork tests can sometimes be misleading, particularly if there is a combination of sensorineural and conductive hearing loss, or if you are completely deaf in one ear and have good hearing in the other.

Other causes of hearing loss

As well as a build-up of earwax, hearing loss may be caused by a number of other conditions, including:

• otitis externa: inflammation (swelling) of the external ear canal as a result of an allergy or infection,
• a foreign body in the ear, which is a common cause in children, and
• keratosis obturans: a rare condition where an excess of keratin (a fibrous substance containing protein) produces a dense, pearly white plug in the external ear canal, which, in some cases, can erode the bony canal.