Why do we have wax in our ears? Do roaches ever crawl in there?

Dear Cecil: When I was about 12, my health teacher told our class that roaches sometimes crawl into sleeping people’s ear canals and get stuck. This causes pain and hearing problems. Within a week of being told this, I suffered pain and hearing problems in one ear. I freaked out, went to the doctor, and fully expected him to pull a roach out of my ear. Instead, he took out a lot of earwax. This marked the beginning of my ongoing battle against earwax. I’ve been wondering ever since: What is earwax for? Why do I produce way too much of it? And was my health teacher right about roaches? Bob Vesterman, via the Internet

Cecil replies:

Afraid so, Bob. But let’s not jump into that right away. Earwax — called cerumen by doctors because they don’t want people to realize they’re talking about earwax — is a normal secretion of special glands in the outer ear. The wax coats the outer part of the ear canal, trapping germs and debris and preventing them from reaching the eardrum. If you didn’t have any your ears would, at a minimum, itch like hell. In other words, earwax is good! You should be organizing Earwax Appreciation Week!

Still, all things in moderation. In most people earwax is produced in modest amounts and migrates out of the ear naturally. But a few people such as yourself are, let’s face it, freaks. You may be tempted to remove excess earwax with a Q-tip or the like. Don’t; you’ll pack it in tighter. Better you should try an over-the-counter preparation such as Debrox or ordinary mineral oil. You put in a dropperful and pack your ear with cotton; the earwax softens and comes out.

If that doesn’t work you need to see a doctor. We found this description of a doctor’s Cerumen Management Kit: a suction pump with a one-eighth horsepower motor and 1,500-cubic-centimeter collection bottle; an otoscope, a lighted ear-examining device; stainless steel ear forceps with “alligator type three-inch serrated jaws,” so the earwax knows who’s boss; a stethoscope — who knows why, maybe they just figure if you’re a doctor you need a stethoscope; an “emesis basin,” I guess to catch the drippings; and a headlight with rechargeable nicad battery pack. I mean, you gotta be ready for anything.

Some doctors say, forget all the apparatus, just squirt in some warm water. But we’ll leave those decisions to the pros.

Now, about roaches crawling into ears. You may think this is some kind of deranged myth. Uh-uh. Happens all the time. In fact, a controversy has raged since 1980 over the best way to get the little bastards out. The conventional remedy: drown the critter with mineral oil. “One cannot use the commercially available roach sprays,” one MD sagely notes, “because of technical difficulty and for possible medicolegal reasons” — i.e., the patient might sue. But mineral oil isn’t ideal either, because the insect takes a while to go through its death throes in the patient’s ear.

One proposed alternative is 2-percent lidocaine anesthetic. The value of this was seemingly demonstrated when a patient showed up at a hospital with cockroaches in both ears. (Unanswered question: what was this guy doing?) Recognizing a golden opportunity for a controlled clinical trial, the attending physicians put mineral oil in one ear. “The cockroach succumbed after a valiant but futile struggle, but its removal required much dexterity on the part of the house officer,” they wrote. In the other ear the doctors put lidocaine. “The roach exited the canal at a convulsive rate of speed” and was promptly stomped by an intern.

But lidocaine has drawbacks too. Another doctor who tried it reported that (1) the roach died in situ and was hell to get out, and (2) the roach had punctured the eardrum, so the lidocaine penetrated the inner ear and the patient had the whirlies for the next five hours. Also, subsequent tests have shown that lidocaine works much more slowly than your top-quality mineral oil.

Promising alternative: suction. Of course, one must take care not to inadvertently seal the ear canal with the suction tip, thereby risking “tympanic membrane barotrauma” and, for all I know, possibly sucking out the patient’s brains.

What else? How about fly larvae in the ear? Happens. Also earwigs, with those scary pincers. You know the story. Earwig gets into a guy’s ear, chews through his brain, causes horrible agony. Finally it stops. The doctors say, good news: the earwig came out the other side! Bad news: it was female and laid eggs. You’ve also heard that this is BS, that earwigs don’t really crawl into ears. Not so; two known cases. The part about eating out your brains may still be a myth, but who knows?

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.