Ear wax blockage
Ear wax blockage affects about 6% of people in the UK and is one of the most common ear problems doctors see. Ear wax, or more correctly cerumen, is essentially an amalgamation of substances, predominantly waxy oils and dead skin cells. It is a by-product of the thousands of ceruminous glands (specialised sweat glands), which lie under the skin of the ear canal and drain into the guard hairs lining the ear canal.
Though ear wax does possess some protective properties, excess or compacted wax can occlude the ear canal and press against the eardrum, which may impair hearing. This is when it needs removal.
Signs
SYMPTOMS OF EAR WAX BUILD-UP
Risk Factors of Ear Wax build-up
Your risk of developing problems from a build-up of ear wax is increased if you have:
Your chances of developing an earwax blockage are also increased if you:
Wax Microsuction
Wax Microsuction is the gold standard ear wax removal technique. It involves the use of an air suction device at low operating pressure to remove wax from the ear, all performed under an operating microscope. It is the safest and quickest means to conveniently remove ear wax and allows full visualisation of the ear canal so that any touching of the sensitive skin layer or fine hairs within the ear canal can, in most instances, be avoided. It is advised that wax softening drops are used by patients a few days prior to attending for wax removal.
Advantages of removing Ear Wax by Microsuction over Syringing:
Microsuction
Microsuction is performed under an operating microscope, with full visualisation of the ear canal and ear drum being maintained whilst removing wax allowing the clinician to clearly identify any outer or middle ear pathology. There are several benefits associated with this method of wax removal:
- Conducted under a high-powered operating microscope (with full ear canal visualisation)
- No water enters the ear
- Wax and other debris suctioned out fully
- Clear specialised and assessed training guidelines on the procedure
- Comfortable supine or seated position during the procedure
- Relatively quick
- Hygienic
Syringing
Syringing is the traditional method of wax removal. It involves water being injected into the ear canal at high pressure, with the aim of trying to get behind the wax to force it out as the water seeps out of the ear canal. There are several problems associated with this method of wax removal:
- The procedure is done blind (without full ear canal visualisation)- high risk of clinical error
- Involves water entering the ear canal–high risk of ear infection
- High pressure of water injection–high risk of eardrum perforation
- Lack of proper specialised training guidelines on procedure–high risk of clinical error
- Heavy handed procedure–high risk of discomfort/ pain
- Not all wax is removed
People with the following are advised to use the Microsuction procedure to remove wax/ debris from their ears to avoid further complications:
- Perforated/ damaged ear drum(s)
- Outer ear infection (Otitis Externa)
- History of outer/ middle ear surgery
- Osteoma/ Exostosis (bony growths in the ear canal)
- Stenotic (narrow) ear canals
- Regular wax build-up
- Ear pain/ sensitivity (otalgia)
- Eczema/ dermatitis in the ear canal
- Hearing aid users
Ear Wax Drops
Wax drops are very useful in wax management. They soften wax, which often enables it to find its own way out of the ear canal through the natural outward migration of the skin cells in the ear canal. However, drops do not dissolve/ eliminate wax on their own and often requires an extraction method. It is advised that everyone attending for wax microsuctioning softens their wax with wax drops. We advise all attending patients to use Earol Olive oil spray, which can be purchased from most Pharmacies, as much as possible prior to their appointment.