A patient with ear blockage and recent history of cerumen buildup is advised on management. Which option is recommended?

• A. Prescribe antibiotics
• B. Advise the use of ear drops containing sodium bicarbonate to help soften the blockage
• C. Recommend water irrigation
• D. Suggest ear candles

Answer: (B)

Cerumen impaction is best managed by softening the wax so it can be expelled or safely irrigated. Ear drops containing sodium bicarbonate work as cerumenolytics, softening the blockage to allow natural movement of the wax or easier removal. This approach targets the cause directly—hard wax obstructing the ear canal—without introducing unnecessary drugs.

Antibiotics aren’t indicated unless there’s an infection, which isn’t implied by simple blockage. Water irrigation can be used once the wax is softened, but it’s not the first-line choice and carries a risk of ear injury if done without proper indication or technique. Ear candles have no proven benefit and can cause burns or further blockage, so they’re not recommended.

So, using sodium bicarbonate ear drops to soften the blockage provides the safest, most effective initial management for cerumen impaction. If symptoms persist, seek professional evaluation.