Earwax that forms a hard lump, i.e. cerumen embolism, should be treated by a physician at a hospital and removed using a cerumen hook, or flushing or suctioning, depending on the situation. The physician needs to be well illuminated and may use forceps to gradually remove the cerumen directly, or hook the cerumen hook deeper into the back of the cerumen to extract it. If the earwax is in the form of a hard mass that is deeper and closer to the tympanic membrane, it will be difficult to remove it directly, and it can be softened first and then removed by flushing or suctioning. Sodium bicarbonate ear drops can be used first to soften and dilute the hard cerumen, and then rinse it out directly with warm saline, or use suction to suck the softened cerumen out of the ear. Patients should be careful not to pull out the ear on their own, which may cause ear skin abrasion or accidental injury to the tympanic membrane, and should seek medical treatment promptly.