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EBP Compendium: Summary of Clinical Practice Guideline

American Academy of Otolaryngology-Head and Neck Surgery Foundation
Clinical Practice Guideline: Cerumen Impaction

Roland, P. S., Smith, T. L., et al. (2008).
Journal of the American Academy of Otolaryngology-Head and Neck Surgery, 139(3 Suppl 2), S1–S21.

AGREE Rating: Highly Recommended


This evidence-based guideline provides recommendations for the management of cerumen impaction. The guideline applies to any population. Specific recommendations are made for special populations. The audience for this guideline includes clinicians likely to identify, manage, or monitor cerumen impaction.


  • Hearing/Balance Screening/Assessment
    • Cerumen impaction should be diagnosed if it is associated with symptoms or prevents the assessment of the ear. Assessment should include a case history and physical examination.
    • Patients with hearing aids should be examined for the presence of cerumen impaction.
  • Hearing/Balance Treatment
    • It is strongly recommended that cerumen impaction be treated when it causes symptoms or prevents clinical examination.
    • Treatment should include cerumenolytic agents, irrigation, or manual removal of cerumen. Additional treatment should be used if cerumen impaction does not resolve.
    • If symptoms persist after removal of cerumen, the clinician should consider alternative diagnoses.
    • Patients with excessive cerumen impaction may be counseled regarding control measures.

Keywords: Hearing Assessment

Access the Guideline

Added to Compendium: November 2010

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