Procedimento de lavagem de ouvido como tratamento para impactação de cerume.

Treatment recommendations:
• American Academy of Otolaryngology - Head and Neck Surgery Foundation treatment recommendations

If cerumen impaction causes symptoms or prevents clinical examination when warranted, treat with 1 or more of the following (AAO-HNSF Grade B)
a. cerumenolytic agent, including water or saline solution (AAO-HNSF Grade C)
b. irrigation (AAO-HNSF Grade B)
c. manual removal other than irrigation (AAO-HNSF Grade C/D)
preparing for irrigation
d. water held in ear canal for 15 minutes before irrigation may decrease number of syringing attempts needed for successful earwax removal compared to immediate irrigation without preparation (level 2 [mid-level] evidence)
e. no apparent differences between various ceruminolytic agents, or comparing cerumenolytics to saline, for augmenting earwax clearance with irrigation
i. preirrigation preparation with cerumenolytic agent does not appear to enhance wax clearance compared to preirrigation saline prep (level 2 [mid-level] evidence)
ii. preirrigation preparation with Cerumenex and Colace associated with similar rate of wax clearing after 1 irrigation in children (level 2 [mid-level] evidence)
f. for patients with persistent earwax after multiple irrigation attempts, 15-minute water prep and 3-day at-home oil prep associated with similar number of additional syringing attempts and overall earwax clearance rate (level 2 [mid-level] evidence)
irrigation
g. irrigation tools include
i. ear syringes (for example, bulb syringe)
ii. oral jet irrigators
iii. 20-30 mL syringe with plastic catheter from butterfly needle (remove needle and wings) or 18-gauge plastic IV catheter
h. ear irrigation by clinician associated with decreased symptoms and increased wax clearance compared to self-treatment with bulb syringe, but self-syringing may reduce need for irrigation by clinician in about half of patients (level 2 [mid-level] evidence)
i. warmed irrigation solution associated with less procedural discomfort and dizziness than room temperature solution (level 2 [mid-level] evidence)
Referência: Dynamed. Roland PS, Smith TL, Schwartz SR, et al. Clinical practice guideline: cerumen impaction. Otolaryngol Head Neck Surg. 2008 Sep;139(3 Suppl 2):S1-S21