AudiologyOnline Phone: 800-753-2160


Cochlear Osia System - October 2023

Relationship Between Cerumen and Cholesterol

Max Stanley Chartrand, PhD, BC-HIS

May 21, 2007

Share:

Question

I work in cardiac rehabilitation and am wondering if there is a relationship between excessive cerumen and high cholesterol levels.

Answer

Yours is one of those questions that gives us the opportunity to expound on some important interdisciplinary considerations. First, I know of no research that shows a causal link between cholesterol and earwax production. In fact, in a cursory file review we find people with hyperlipidemia who exhibit dry ears and those with normal lipids that make excessive earwax.

A better biomarker for prediction of earwax production can better be found in the keratin (corneum stratum) status of the external auditory canal (EAC). Hence, to afford the appropriate mix of cerumenous and sebaceous secretions into functional earwax, one needs to have a good, healthy layer of keratin protein over the top of the entire epithelium of the EAC.

But because keratin extends in all directions from the umbo of the tympanic membrane (TM), migrating outward at the rate of approximately 1mm per day and terminating at the hair follicles near the aperture or opening of the EAC, an interruption of the process can cause some unhappy and unhealthy results. For instance, we are seeing more and more so-called "impacted wax" cases that are actually keratosis obturans cases, where the earwax merely coats the outer portion of the mass. In such cases, about 3 or 4 years' (or more!) worth of interrupted keratin has wrapped around itself much like an ingrown toenail. In fact, like the ingrown toenail, dead skin cells, bacteria, fungi, and desquamated debris get trapped inside to the point that the mass begins to take on a life of its own. When that happens, the mass (which appears in every respect as impacted earwax) can cause neuroreflex issues of the vagus, trigeminal, and facial nerves and their respective mechanoreceptors.

A good example of an anomaly created as a result of this 3 or 4 year old mass is pressure on the Arnold's Branch of Vagus, which can produce a chronic cough and/or gag reflex. It can also present tension on the pericardium of the heart, persistent nausea in the stomach, and watering eyes, in some cases. Too often we see cases that, instead of having the desquamated mass removed are given a long course of antibiotics, decongestants, and/or anti-asthmatic medication: All because of the pressure on the neuroreflex complex in the EAC! I would not be surprised if some angina-like cases also fall into this category. Remove the mass and the symptoms disappear in due time.

This knowledge can elude even many hearing health professionals, as by all appearances what we're talking about appears to be a huge accumulation of earwax. But, no more than a few swishes of warm antiseptic water will reveal that the earwax is merely a façade. The rest is the wrapped keratin and septic debris mentioned above. This information should garner the attention of all branches of medicine and clinical interest. For symptoms involving any and all have shown to present as a result of neglecting this important aspect of health.

Please, consult the following link for more information about keratin and the neuroreflexes www.hearingreview.com/article.php?s=HR/2006/03&p=14. Even though the referred article focuses on problems related to hearing aid adaptation, the underlying principles are explained so that all health professionals can be alert to the appearance of abnormal keratin progression, and possible symptoms that may arise therefrom.

Max Stanley Chartrand, M.A., serves as Managing Director of DigiCare Hearing Research & Rehabilitation, Colorado City, CO. He is also author of several textbooks and hundreds of articles in health publications, and lectures worldwide on issue of hearing and cognitive health. Correspondence: www.digicare.org.


Max Stanley Chartrand, PhD, BC-HIS

Director of Research

Max Stanley Chartrand serves as Director of Research at DigiCare Hearing Research & Rehabilitation, Rye, CO, and has served in various capacities in research and development and marketing in the hearing aid and cochlear implant industry for almost 3 decades. He has published widely on topics of hearing health and is the 1994 recipient of the Joel S. Wernick Excellent in Education Award. He is currently working in the Behavioral Medicine doctoral program at Northcentral University. Contact: chartrandmax@aol.com or www.digicare.org.


Related Courses

Implementation of Cochlear Implants: Enhanced Candidacy Criteria and Technology Advances
Presented by J. Thomas Roland, MD Jr.
Recorded Webinar
AudiologyOnline

Presenter

J. Thomas Roland, MD Jr.
Course: #37377Level: Intermediate1 Hour
  'Although we do not do ABI at our clinic, this was extremely interesting to learn about'   Read Reviews
The participant in this course will understand the extended candidacy criteria with cochlear implantation and expectations. The course will cover implanting under age one, hybrid hearing with cochlear implantation, CI under local anesthesia, single-sided deafness, cochlear implantation, and auditory brainstem implantation.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Conductive/Mixed Hearing Loss: Otosclerosis and Other Causes
Presented by Daniel Zeitler, MD, FACS
Recorded Webinar
AudiologyOnline

Presenter

Daniel Zeitler, MD, FACS
Course: #34564Level: Intermediate1 Hour
  'Great presenter'   Read Reviews
This course will review middle ear mechanics and conductive hearing loss. A highlight of differences and similarities between conditions will be discussed. A review of audiological and otological work-up will be covered and as well as a brief introduction to surgical and non-surgical treatments.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Current Topics in Audiology Treatment, in Partnership with Thieme Publishers
Presented by Jason Galster, PhD
Recorded Webinar
AudiologyOnline

Presenter

Jason Galster, PhD
Course: #32010Level: Introductory1 Hour
  'Nice overview!'   Read Reviews
This course will review current topics in audiology treatment that are detailed in the upcoming book by Thieme publishers. Editor Dr. Jason Galster will provide a tour of content focused on the treatment of hearing loss through amplification, implantable solutions, and a variety of additional techniques.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

IONM During ENT Procedures - Mastoidectomy, Vestibular and Tumor Excision
Presented by Cheryl Wiggins, AuD, CNIM, D.ABNM
Recorded Webinar
AudiologyOnline

Presenter

Cheryl Wiggins, AuD, CNIM, D.ABNM
Course: #35598Level: Intermediate1 Hour
  'Great presentation, appreciated the professional manner and expansive knowledge of the presenter'   Read Reviews
This course provides a brief overview of Intraoperative Neuromonitoring (IONM) during select ENT surgical procedures. The course will include review of the surgical procedure/morbidity, anatomy/physiology at risk, pathology/diagnosis, IONM/Alert criteria & specific IONM case examples.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Vestibular Schwannoma: Medical and Surgical Evaluation and Management
Presented by Christopher Welch, MD
Recorded Webinar
AudiologyOnline

Presenter

Christopher Welch, MD
Course: #36879Level: Intermediate1 Hour
  'I found the treatment options and the reasons for a patient to choose one or the other really fascinating'   Read Reviews
This course reviews the common symptoms and findings associated with vestibular schwannoma, as well as workup and differential diagnosis for lesions of the cerebellopontine angle. A discussion of the natural history of vestibular schwannoma and general current paradigms for treatment are included.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.