Cerumen lipid and keratin aggregates

Cerumen lipid and keratin aggregates, commonly referred to as earwax, are complex physiological substances found in the external auditory canal. They are composed of a mixture of desquamated keratinocytes (keratin) and secretions from sebaceous and ceruminous glands, containing lipids such as long-chain fatty acids, cholesterol, and squalene (Guest et al., 2004). The primary biological function of this aggregate is to provide a protective, acidic, and antimicrobial environment that lubricates the ear canal and traps foreign debris (Roeser & Ballachanda, 1997). However, when the natural self-cleaning mechanism fails, these aggregates can form an impaction, leading to conductive hearing loss, pain, and tinnitus (Horton et al., 2020). In clinical pharmacology, this mass is the therapeutic target for cerumenolytic agents, which are designed to soften or dissolve the aggregate to facilitate its removal. These agents work through various mechanisms, including the release of nascent oxygen to mechanically disrupt the wax or the use of surfactants to emulsify the lipid components (StatPearls, 2023).

Other names

EarwaxCerumenCeruminous massCerumen impaction

Cerumenolytics facilitate the disintegration of the aggregate by either inducing oxidative fragmentation, emulsifying lipids, or softening the keratin-lipid matrix through hydration and lubrication.