Earwax: Should It Be Removed?

I read this article on Medscape about earwax:

The removal of a cerumen can be dangerous, particularly if unsafe methods are used.

Earwax is an important defense against infection. Nevertheless, it is thought by most people to be a cosmetic nuisance that denotes uncleanliness. Its continuous removal compromises the integrity of the ear’s defenses against infection and can contribute to cerumen impaction, a leading cause of impaired hearing.

According to Wikipedia:

Excessive earwax may impede the passage of sound in the ear canal, causing conductive hearing loss.

One thing I learn and should remember is this (and you should too):

Cotton swabs should be used only to clean the external ear. (insert exclammation point here)