Impacted cerumen can cause problems ranging from general discomfort to loss of hearing function. In the second of two articles, Kat Millward examines the best methods for softening and removing cerumen from the ear without causing any damage Our ears are essential for both hearing and balance. Up to 4% of the population will have difficulties with their ears relating to impacted cerumen and many of them will present in primary care with ear discomfort or hearing difficulties. In the second of two articles, we review the evidence and recommended best practice for managing impacted cerumen, including ear drops, irrigation, microsuction and instrumentation.