剖析耳屎 清除耳垢的好处与坏处

If it still needs help, try gentle irrigation with a bulb syringe or tilt your head in the shower, say doctors. After a few minutes, straighten up and let the water run out again. 'Water works just as well as a $10 bottle of ear drops, ' says Dr. Rosenfeld. But doctors say high-pressure water streams, including repurposed jet-tooth cleaners, can be damaging.
医生们说，如果还不管用，就试着用洗耳球小心灌耳。或者在淋浴时歪着头，几分钟后，直起身让水再次流出来。罗森菲尔德博士说：“水和10美元一瓶的滴耳液一样管用。”但医生们表示，高压水流，包括改造过的洗牙器，可能会造成伤害。

Over-the-counter 'ear vacs' are also generally ineffective. In a British study of 16 patients, published in Clinical Otolaryngology in 2005, none reported hearing better after using an ear vac. There was no improvement in visibility of the ear drum and in fact, no ear wax removed at all.
一位母亲在清理儿子耳朵中的耳垢

Another problem with do-it-yourself earwax removal: It's hard to see what you're doing, unless you pop for a pricey product like the Coden Ear Scope TV ($150 to $300 on eBay), a lighted magnifying camera that relays images of your ear canal to a computer or TV screen.
药店卖的“真空吸耳器”通常也没有效果。2005年英国一项针对16名病人进行的研究的论文发表在了《临床耳鼻喉科学》(Clinical Otolaryngology)上，这些病人中，没有人称使用真空吸耳器后听力有好转。鼓膜能见度也没有改善。实际上，耳垢根本没有被清除。

Doctors are particularly scornful of ear candling. 'I think it's the work of the devil, ' says Dr. Stackpole. The process uses a long, hollow cone-shaped candle. The patient lies down on one side, the bottom of the candle is placed in the ear and the other end is set ablaze, theoretically creating a vacuum inside that draws out the wax.
自己挖耳垢还有一个问题：很难看到自己在做什么，除非你购买了像Coden Ear Scope TV（eBay上售价为150美元至300美元）这样昂贵的产品，它有一个发光的放大摄像头，可以将耳道中的图像传输到电脑或电视屏幕上。

Many physicians -- and the Food and Drug Administration -- warn that it can drop hot wax into delicate ear tissues, cause burns or even set hair on fire. Doctors also say it doesn't work -- that brown, gooey stuff inside the cone is candle wax, not earwax.
医生们对耳烛尤其不屑一顾。斯塔克波尔博士说：“我认为那是魔鬼干的勾当。”这种方法使用一根细长中空的锥形蜡烛。病人侧躺着，蜡烛底部放在耳朵上，并点燃另一端，这样理论上可以在内部产生真空，吸出耳垢。

If softening drops and irrigation don't work, it's time to seek professional help -- from a nurse, physician's assistant, primary-care physician or ear, nose and throat specialist. Many rely on drops and irrigation, but some also use small suction devices and a wired loop instrument called a curette. Some ENTs also have microscopes that attach to the wall and give them a 3-D view into the canal.
许多医生──以及美国食品和药物管理局(Food and Drug Administration)──警告说，这可能使热蜡滴入娇嫩的耳组织，导致灼伤，甚至点燃头发。医生们说，这种方法不管用──锥管内的棕色胶状物是烛蜡，而不是耳垢。

Even trained specialists can get carried away when it comes to removing earwax, says Robert Folmer, an investigator at the National Center for Rehabilitative Auditory Research in Portland, Ore. He co-authored a 2004 survey in which 11 of 2, 400 patients at an Oregon hearing clinic said their tinnitus was caused by a professional earwax removal.
如果软化滴耳液和灌耳不管用，那么是时候找专家帮忙了──可以是护士、医生助手、初级护理医生甚或耳鼻喉科专家。许多人依靠滴耳液和灌耳，但有些人也使用小吸管或被称作耳刮匙的铁圈形工具。有些耳鼻喉科专家还使用附在耳壁上的显微镜，好看到耳道中的3D图像。

Other studies have found that eardrum perforation, infection and hearing loss occur at a rate of about 1 per 1, 000 irrigations. 'Some doctors are really determined, but it isn't like it's a construction project, ' Dr. Folmer says. 'You've got to be gentle.' He suggests that patients ask a clinician what method they plan to use, and how many times they've done the procedure.
使用耳刮匙让诊疗过程更像是“手术”，它有自己的诊疗标准，医疗费用可高达100美元。只用水冲洗不能保证符合诊疗标准。许多药店的坐堂医生还提供60美元至80美元（根据方法而定）的清除耳垢服务。

Aside from earwax 'overproducers, ' who can benefit from a professional cleaning a few times a year, doctors say the average person should not require ear cleaning unless the wax is causing bothersome symptoms or impeding a doctors' ability to examine the eardrum. 'I'd tell the doctor, 'I really like my earwax. Leave it alone, please', ' says Dr. Rosenfeld.
俄勒冈州波特兰(Portland)美国国家听力康复研究中心(National Center for Rehabilitative Auditory Research)的调研员罗伯特?福尔默(Robert Folmer)说，即使是训练有素的专家在清除耳垢时也可能会失手。他在2004年参与了一项调查，调查对象是俄勒冈州一家听力诊所的2,400名病人，其中11人称，他们的耳鸣是专家在清除耳垢时导致的。

But some patients can't. Dr. Stackpole says she gives earwax-removal addicts an antibiotic cream to dab at the opening of their ears once a day. 'I do that rather than telling them to do nothing, because they are not capable of doing nothing, ' she says.
还有些研究发现，每1,000次灌耳中，大约会出现一次鼓膜穿孔、感染和听力丧失。福尔默博士说：“有些医生很自信，但这不是盖房子。你必须手法轻柔。”他建议病人询问医生他们计划使用的方法，以及治疗将进行多少次。