As audiologists, one of the most common inquiries received relates to removing ear wax. Ear wax impaction is a common issue, with presentation worldwide.
Ear wax production is natural and along with the tiny hairs in the ear canal, assists with trapping foreign particles and dust. Ear wax usually secretes itself naturally; however, if an individual secretes an excessive amount of wax and it isn’t cleared properly, the wax may become impacted.
Common signs of ear wax impaction include:
Ear wax removal is available at Toronto Hearing Consultants. Various different methods are used depending on the wax texture, depth, ear canal condition, and patient case history.
Method 1: Instrumentation
Curettes (little spoons) and forceps can be used to extract wax sitting closer to the opening of the ear canal. The curettes can be plastic or metal. Curettes and forceps are used when wax is easily accessible, and is the preferred method if possible as the canal is not exposed to moisture and the risk of infection is reduced. Loupes (converged binocular vision glasses) are often used by the audiologist while conducting wax removal to ensure a clear view of the ear canal.
Method 2: Irrigation
Toronto Hearing Consultants uses a low pressure irrigation system in order to flush wax out of the ear canal. Irrigation can be completed with or without an ear softening pretreatment. Low pressure irrigation is safe and effective at removing wax; and will not cause trauma to the eardrum. Irrigation is not used if there is a perforation (hole) in the ear drum, a tube is present, there is a patient history of middle ear trauma or disease, an ear infection, or with patients who experience vertigo. During the procedure, the audiologist will gently spray water into the canal, while checking periodically for the wax to be cleared and emitted from the canal. Irrigation can be a little bit messy, and it is important to note the patients shirt can get wet in certain circumstances.
Method 3: Microsuction
A type of wax removal method commonly called ear vacuuming. Along with a loupe (converged binocular vision glasses), the audiologist uses a tiny vacuum to gently suction and dislodge the wax in the ear canal. The patient can feel a slight suction sensation in the ear while this is occuring, and will also hear a crackling or high pitched squeaking sound being emitted from the vacuum as it is suctioning. Once the ear wax has been dislodged, the audiologist will remove the wax with a pair of forceps. Unlike irrigation, microsuction can be performed on patients with a hole in the ear drum, a history of middle ear surgery or disease, or a very mild outer ear infection. However, some patients do complain of the sound emitted by the vacuum while it is suctioning.
Method 4: Cerumenolytics (Ear Wax Softening Agents)
Ear wax softening agents are usually used in conjunction with one of the other methods above to assist in the removal of ear wax. At Toronto Hearing Consultants, a product called Audiologist’s Choice is available for purchase if patients would like to work on softening the wax at home prior to the appointment. The softer the wax, the easier it is to remove, and it is recommended that some softening be completed prior to coming to the appointment regardless. If purchasing Audiologist’s Choice is not an option, oil may be used to soften the wax or an over the counter product from the pharmacy.