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.