Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary

The American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology–Head and Neck  Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). | Otolaryngology– Head and Neck Surgery

This clinical practice guideline is as an update, and replacement, for an earlier guideline published in 2008 by the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF).1 An update was planned for 5 years after the initial publication date and was further necessitated by new primary studies and systematic reviews that might suggest a need for modifying clinically important recommendations. Changes in
content and methodology from the prior guideline include the following:

  • addition of a consumer advocate to the guideline update group (GUG)
  • 3 guidelines, 5 systematic reviews, and 6 randomized controlled trials (RCTs)
  • emphasis on patient education and counseling with new explanatory tables
  • expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences
    of opinion
  • enhanced external review process to include public comment and journal peer review
  • new algorithm to clarify decision making and action statement relationships
  • 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination
    of care.

Full reference: Schwartz, S.R. et al. (2017) Clinical Practice Guideline Update): Earwax (Cerumen Impaction) Executive Summary. Otolaryngology– Head and Neck Surgery. Vol. 156 (no. 01) pp. 14–29


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