Cerumen, or “earwax” as it is often referred to, is produced by the cerumen glands in the cartilage of the external ear canal. Under normal circumstances, cerumen is a dry flake that protects the outer ear canal and the inner tympanic membrane, and falls out on its own with the movement of the head or jaw joint. When cerumen secretion is excessive or its discharge is obstructed, it gradually accumulates in the ear, forming a mass and blocking the external ear canal, resulting in hearing loss, tinnitus, ear congestion, ear pain, and even vertigo. This disease is most prevalent in the elderly and in people with cognitive impairment, with a prevalence of 19%-65%. Examination: An otologic examination reveals a yellowish-brown or brownish-black cerumen obstruction in the external ear canal, and the eardrum is not visible. The endoscopic examination makes it easier to diagnose cerumen embolism. Through the endoscope we can clearly observe the size, shape, and location of the cerumen, and it also helps to make a differential diagnosis and understand whether the patient has other external or middle ear diseases at the same time, especially to differentiate it from diseases such as external ear canal cholesteatoma. Treatment: 1. Cerumen hook removal method: For patients with hard but movable cerumen, use a cerumen hook to gently insert into the deep part of the external ear canal through the space between the posterior upper wall of the external ear canal and the cerumen, control the hand force to avoid hurting the eardrum, hook the cerumen and then gently rotate the cerumen hook and slowly pull it outward. However, this method is not recommended for patients with cerumen close to or even attached to the eardrum and for younger children to avoid injury to the external auditory canal or eardrum due to the difficulty of children to cooperate with the cerumen hook. 2.Rinsing method: For patients with hard cerumen and poor mobility, we first instruct the patient to use 3%-5% sodium bicarbonate solution or 3% hydrogen peroxide solution to drip the ear for 3-5 days, 5-7 times a day, soaking for 15 minutes each time to make the cerumen fully softened. Afterwards, the upper posterior wall of the external ear canal is flushed with a 20ml syringe or professional external ear canal irrigator to flush out the cerumen with the force of reflux, and finally wiped clean with a dry cotton ball. However, it should be noted that: (1) The temperature of the rinsing solution should be controlled at 38-42°C as much as possible, not too cold or too hot, in order to avoid temperature discomfort to stimulate the vagus causing vertigo and instability of the patient. (2) The direction of the rinse should be oblique to the back and aimed at the upper posterior wall of the external auditory canal. Direct impact of the cerumen may flush the cerumen deeper into the external auditory canal and may also cause damage to the eardrum. 3. Flushing should be prohibited if the eardrum is perforated due to purulent otitis media or other causes. (3) Suction method: For patients with a narrow external ear canal that is not easily flushed out by the flushing method, we can use the suction method of suction to soften the cerumen in the same way as the flushing method described above. After the cerumen is sufficiently softened, we use the suction device to suction the softened cerumen. It is important to note that the force of the suction device should not be too great to avoid hurting the patient’s eardrum. Finally, after cerumen removal, if there is inflammation in the external ear canal, topical antibiotics are needed for symptomatic treatment; if there is a combined fungal otitis externa, topical rubbing with drugs that have antifungal effects can be used.