Tinnitus is the perception of sound, such as ringing, buzzing, or humming, when no external sound is present. While it can be a symptom of various underlying health conditions, one common and easily reversible cause is the accumulation of earwax, medically known as cerumen. Cerumen is a naturally produced substance that cleans, lubricates, and protects the ear canal. When this substance builds up and hardens, it causes cerumen impaction, meaning the ear canal is blocked. This blockage can directly result in tinnitus, making earwax removal a primary step in diagnosis and treatment.
Cerumen Impaction as a Source of Tinnitus
Cerumen impaction is defined as an accumulation of earwax that causes symptoms or prevents a medical professional from assessing the ear canal or eardrum. Although earwax is naturally expelled from the ear canal through jaw movement, this self-cleaning mechanism can fail. Factors such as narrow ear canals, increased ear hair, the use of hearing aids, or improper cleaning with cotton swabs can interfere with the wax’s natural migration.
The symptoms of impaction often include a feeling of fullness in the ear, earache, itchiness, and decreased hearing ability, in addition to tinnitus. Cerumen impaction is a frequent cause of temporary tinnitus. When tinnitus results from this obstruction, the presence of these other physical symptoms helps distinguish it from other, more complex causes.
The Physical Mechanism of Sound Interference
The blockage caused by impacted earwax leads to the perception of sound through two main physiological pathways: direct pressure changes and conductive hearing loss.
Direct Pressure Changes
One mechanism involves direct pressure changes within the ear canal. The hardened cerumen mass can press against the delicate tympanic membrane (eardrum), affecting its ability to vibrate and transmit sound normally. This mechanical irritation or pressure alteration stimulates the auditory system, which the brain interprets as tinnitus.
Conductive Hearing Loss and Central Gain
The second mechanism is the masking effect caused by conductive hearing loss. The physical obstruction muffles external sounds, resulting in a temporary hearing deficit. When the brain receives less external auditory input, it attempts to compensate by increasing its internal sensitivity, a process known as central gain. This heightened sensitivity makes normal internal body noises, such as blood flow or neural activity, much more noticeable and perceived as tinnitus.
Professional Removal and Symptom Resolution
Tinnitus caused solely by cerumen impaction resolves once the blockage is safely and completely removed. It is recommended to seek professional help for removal, as attempting to clear the wax at home with cotton swabs or other instruments can push the cerumen deeper, worsening the impaction or potentially damaging the eardrum. Healthcare providers use safe and effective methods to clear the blockage, including gentle irrigation, manual removal with specialized tools, or microsuction, which uses a small vacuum.
For many individuals, tinnitus improves immediately or resolves completely within a few hours to a few days following the procedure. This rapid resolution occurs because physical pressure is relieved and normal hearing returns, allowing external sounds to mask internal noises. If tinnitus persists beyond two weeks, the earwax was likely a contributing factor to an existing condition, and further medical evaluation is necessary to identify the primary cause.