title: Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary
abstract: The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment. An updated guideline is needed due to new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials) and the need to add statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.
authors.affiliation: 1 Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA.
authors.forename: Seth R
authors.initials: SR
authors.lastname: Schwartz
authors.affiliation: 2 Division of Otolaryngology, Childrens Hospital of San Diego, San Diego, California, USA.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Magit
authors.affiliation: 3 Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Rosenfeld
authors.affiliation: 4 Premier Hearing Center, Albuquerque, New Mexico, USA.
authors.forename: Bopanna B
authors.initials: BB
authors.lastname: Ballachanda
authors.affiliation: 5 Pomona Pediatrics, Pomona, New York, USA.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Hackell
authors.affiliation: 6 College of Nursing, Wayne State University, Detroit, Michigan, USA.
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Krouse
authors.affiliation: 7 Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Lawlor
authors.affiliation: 8 Georgetown University School of Medicine, Washington, District of Columbia, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lin
authors.affiliation: 9 Division of Otolaryngology, University of Connecticut Health Center, Farmington, Connecticut, USA.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Parham
authors.affiliation: 10 University of Michigan Health System, East Ann Arbor Health Care Center, Ann Arbor, Michigan, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Stutz
authors.affiliation: 11 Consumers United for Evidence-based Healthcare, Davis, California, USA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Walsh
authors.affiliation: 12 Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Woodson
authors.affiliation: 13 Yale New Haven Hospital, Southern New England Ear Nose Throat & Facial Plastic Surgery Group, LLP, New Haven, Connecticut.
authors.forename: Ken
authors.initials: K
authors.lastname: Yanagisawa
authors.affiliation: 14 AAO-HNSF, Alexandria, Virginia, USA.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Cunningham
mesh_terms: D002571:Cerumen; D004427:Ear Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: cerumen; clinical practice guideline; ear candling; ear coning; earwax; impaction