Ear wax removal &
Ear Cleaning

Earwax Blockage: Understanding The Full Ear

Earwax, medically termed cerumen, is made up from our ear canal ceruminous and sebaceous glands secretions, together with dead skin flakes, normal skin bacteria, water and hair. Earwax is our innate barrier to protect our ear passage against external damages such as trauma, water, insects, foreign bodies and infection.

The inborn earwax migration theory.  Inside our ear canal, the skin cells epithelial layer brushes and moves the earwax from the inner part to the external part of the ear. The motion clears off excessive earwax.

Reasons for ear block or earwax becomes impacted as a result of:

  • Excessive production of earwax
  • Structural causes of ear canal such as a narrowed or an impedance of ear canal
    • Risks of earwax impaction is higher in ear canal disease. This can be due to underlying bone disease or skin conditions such as infection and eczema.
    • Tortuously tightly structured ear canal or repetitive injury and infection of the ear canal predisposes build-up of earwax.
  • The innate earwax migration that are inefficacious
    • As we grow older, the ear wax tends to be harder and less fluid-based, this is due to the shrinkage of glands inside the ear canal. Earwax migration mechanism becomes less efficacious.
    • Self-instrumentation with Q-tip, cotton buds can potentially push the ear wax deeper into the ear canal, obstructing the passage.
    • Foreign bodies such as hearing aids or ear plugs can also impede the ear canal.

Most patients have no symptoms despite having earwax build-up.

Others may present with

  • Blocked ear, feeling of pressure inside the ear
  • Reduced hearing ability
  • Ear pain
  • Dizziness and vertigo
  • Itchiness over the ear
  • Ringing of the ear (also known as tinnitus)

Earwax blockage is common, affecting 1 in 10 children, 1 in 13 adults and a third of the elderly people.

Is It Necessary To Remove Ear Wax?

If you do not have any symptoms from your earwax, you are not advised for routine removal of earwax. Having said that, for those who are young, or those with medical issues leading to incapability in expressing their symptoms, ear wax removal has been proven to be beneficial in improving hearing. The elderly can benefit from earwax removal as it is noted that hearing loss secondary to impacted ear wax can lead to social isolation and cognition function deterioration.

Can earwax cause vertigo? Earwax impaction can lead to unpleasant symptoms such as pain and discomfort, hearing loss, dizziness, vertigo or even ringing of ear. You should consider earwax removal if you experience any of these symptoms.

How To Treat Earwax Blockage or Remove Hard Stubborn Earwax?

Chemical Ear Drops

This is a painless, easy, safe and effective way of removing ear wax. It works by softening and breaking down the wax, lubricating the canal, allowing the wax to be cleared easily. It is suitable for people with perforated ear drum, or other previous ear surgeries. Chemical ear drops are advisable for use approximately 3-5 days only, as prolonged use can irritate the skin lining of the ear canal, which may subsequently lead to ear discomfort, pain, infection, dizzy spells or even temporary loss of hearing.

Ear Irrigation

This is a commonly used method to clear excessive impacting earwax. The procedure uses the force of water to flush out and dislodged earwax. This method is not recommended for people with ear infection or perforated ear drum. There is a risk of infection of the ear canal when the irrigated water and the wax are not completely removed. Other risks include injury and perforation of the ear drum, ear pain and discomfort, hearing loss, dizziness, and ringing of the ear.

Manual Clearing

This method involves adequate visualization of the ear canal with microscope or otoscope, coupled with the use of instruments such as suction, forceps, curettes, hooks to remove the obstructing earwax. This is particularly useful in people with a hole in the ear drum or those with ear infection. The drawback of this procedure is that it requires a skilled clinician with proper equipment. The risks of this procedure include ear discomfort, injury to the ear canal and ear drum leading to bleeding, abrasion or even a hole in the ear drum.

Is EarWax Removal Necessary

Ear Candling
Ear candling is not safe for ear wax removal as there is a risk for injuries or burns.

What can go wrong when you attempt to clean your own ears?

Removing earwax yourself can be dangerous. Here are the possible complications:

  • Inadvertent injury to the ear. Self-instrumentation with Q tip cotton bud or ear candling can damage the lining of the ear or even perforate the ear drum. That is the reason why you shouldn’t clean your ears with a cotton swab.
  • Infection of the ear. Improper ear cleaning can increase the risk of ear canal or middle ear infection.

What can you do if you suspect of impacted earwax?

  • Avoid using finger to dig the ear.
  • Avoid self-attempting of removing cerumen with Q tip cotton bud or ear candling.
  • Consider chemical ear drops to soften and dissolve ear wax.

Consult a GP doctor if you have any persistent ear symptoms, and listen to your doctor’s advice.

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What is the best way to remove ear wax?

Is Ear Syringing Safe? Can Syringing Ears Cause Damage?

Ear syringing or ear irrigation is relatively effective but can be associated with significant side effects. Earwax irrigation depends on build-up of water jet force directed to the wax to push the wax out of the external canal of the ear. In cases where the earwax has completely occluded the ear canal, irrigation may be unsuccessful and worsen the situation by pushing the earwax further into to the ear drum. 

However, earwax irrigation can complicate with injury to skin linings of the ear canal, leading to pain and infection, vertigo or even ear drum perforation. Ear syringing is not suitable for those with middle ear disease or perforated ear drum or history of ear surgery. 

Microsuction has an edge in these situations by giving an accurate actual view of the ear canal, allowing precise and safe way of dewaxing the ear.

Earwax Microsuction: Safe & Effective Way To Remove Ear Wax


Why You Should Consider Microsuction for Earwax Removal?

  • Removal of ear wax that is causing discomfort or symptomatic to the patient
  • Removal of foreign objects
  • External and middle ear infection – Microsuction allows removal of abnormal discharge or ear wax for better absorption and penetration of medicated ear drops.

Is Ear Wax Microsuction Safe?

Earwax Microsuction is an effective, well-tolerated, safest method of clearing the ear canal. This is performed with an ear microscope which allows complete visualization of the ear canal to aid the suctioning procedure.  This enables precise clearing of the ear whilst causing less discomfort to the patient during the process. This method often allows instrumentation and dual handed working for the practitioner in clearing the impacted earwax safely.  It is frequently performed to remove impacted earwax, abnormal ear discharge or foreign bodies when other methods have tried to no avail.

Microsuction is one of the safest mode to clean your ears. If you have any concerns with your ears and keen to find out more, speak to your trusted doctor.

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What To Expect when consulting doctor on ear wax removal?

Your doctor would want to know any previous tried treatment for your ear problem, such as previous ear syringing, how many times attempted, what went wrong, and any other method that managed to resolve your problems in the past.

Do inform your doctor if you have any symptoms such as dizziness, vertigo, hearing loss, or ringing sound in the ears – as these symptoms can be worsen by microsuction procedure.

Your doctor will also obtain a surgical ear history or would like to know whether you have had any ear drum procedure or ear implant inserted before. You should alert your doctor if you have a history of perforated ear drum as it can be weaker and susceptible to damage during microsuction procedure. You should also inform your doctor if you have any underlying skin conditions such as eczema or psoriasis.

Things You should Know about Earwax Microsuction

  • The procedure takes about 10-15 minutes only.
  • Your doctor will examine your ear canal by carefully pulling the outer ear and inserting an ear speculum and focus his microscope.
  • You will expect noise when the suction is started.
  • Your doctor may need to take out the suction from your ear canal as the suction tip can be blocked, and he may need to dislodge the tip then re-insert the suction into your ear canal.
  • You may be asked to stay still throughout the procedure.
  • You may experience some pain, discomfort or dizziness during procedure.
  • You are expected to experience resolution of your ear symptoms shortly after the procedure.
  • You may need further microsuction sessions, depending individual condition.
  • Patients with ear infection should undergo microsuction and ear irrigation should not be attempted
  • Patient who has a build up of ear wax which are causing symptoms;
  • Patient with anatomical variations of the ear canal;
  • Patient with hearing aids
  • Children who experience the above and are able to follow simple understand instructions
  • Patient can apply ear wax softening drops for example olive oil
  • Patient should continue applying the drops until they have the procedure.
  • A formal hearing test should be perfomed after microsuction to ensure hearing has returned after the obstruction has been removed

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