Ear wax is produced by the body and protects the inside of the ear canal from injury and infection. As such it should only be removed if it causes symptoms such as:
- Difficulty hearing
- Ringing in the ears
- A feeling of blockage
Common causes of excess wax occurring include infections in the outer ear, eczema, narrow ear canal, aging, making too much ear wax and using cotton swabs or tools to clean the outer ear.
Methods of removal
Common methods of removal include cerumenolytics (such as waxol, cerumol etc), syringing or ear microsuction.
Due to potential complications with syringing this is no longer available at Stirk.
Ear microsuction is generally regarded as the safer preferred option.
Cerumenolytics can still be used at home, but it is important to remember they should not be used in the presence of infection or perforation of the ear drum. If there is any doubt about these conditions being present, then it is suggested that you make an appointment.
If you have recurrent ear wax problems (requiring removal greater than once per year) it is recommended that you use a cotton ball dipped in mineral oil and place this in the external ear canal for 20 minutes once per week (combined with eight hours of not wearing a hearing aid overnight).
Another option is to use a topical emollient shown in clinical trials¹ (Ceridal® lipolotion) to reduce the recurrence of wax (2ml in the effected ear/s once per week). An equivalent emollient liquid- (paraffin 70% cyclomethicone 15% buxus chinensis (jojoba oil) 15% oil) can be purchased from compounding pharmacies (eg Pharmacy 777 Kalamunda) over the counter.
Ear microsuction is a more costly option than syringing due to the need for additional time required, a doctor skilled in the procedure and consumables that are required per patient.
At present our fees are $110 pensioner/health care card holder ($33.05 after rebate) and $140 standard ($63.05 after rebate) for both ears (no discount for one ear). Unfortunately, we have been advised that there is no specific medicare rebate for GPs to use for this procedure apart from a standard consultation.
A repeat procedure is possible particularly in the case of an underlying infection. It is recommended that you use 2 to 3 drops of olive oil at least 3 (5 to 7 is preferred) nights before the procedure to improve chances of removal at one sitting. Fill the ear slowly with oil to avoid airlocks whilst lying down for 5 minutes with cotton ball over outer ear. Do not use if suspected hole in eardrum.
What is microsuction?
Microsuction is the precise suction of the ear canal while viewing the area through a microscope. It’s the most advanced method of ear wax removal, and in the past was only available from a specialist ENT clinician.
It provides a water-free alternative to removing earwax.
How long does it take?
Approximately 15-20 minutes
Is it painful?
Ear-suction can be noisy, and you may feel some mild discomfort. If you experience any pain or dizziness, you should let your doctor know and the process can be stopped immediately.
What you need to do
Before your appointment, you need to use wax softening drops. Drops from the chemist like Waxol or Olive Oil twice a day for at least 3 days prior to your appointment. Please discontinue drops if ears become irritated or painful or if you suspect a hole in your eardrum or trauma.
Direction for use:
- Tilt head to one side or lie on your side
- Place 3 to 5 drops in the ear
- Keep head tilted for several minutes before turning to the other side
- Put a piece of cotton wool in the outer ear to keep oil from leaking out
- Repeat the same procedure on the other ear
Cost of procedure
Private $140 (rebate $76.95)
Pensioner Concession $110 (rebate $76.95)
Things that you should avoid
Do not use ear drops if you are suffering a perforated ear.
Do not insert ear buds or other object in ears.
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