Endoscopic Microsuction is becoming the more popular procedure to remove ear wax – where the Audiologist, Hearing Aid Dispenser or ENT Doctor uses a visual camera (an oto-endoscope) which the specialist slowly inserts into the ear canal.
This helps to clearly display the wax removal process: whether using low-pressure microsuction with a sterile tip, or using manual methods with an ear hook or Jobson Horne
The endoscope is an instrument used to look inside the body, and when attached to a video monitor, such as an iPod (using an “iCLEARscope®” from CLEAR WAX) which our “WaxBuster” audiologists use, the barrel packs a battery which emits a bright light source which clearly illuminates the inside of ear canal in HD (high definition) quality. This provides a detailed, panoramic view of the entire ear canal and eardrum – helping the specialist to perform safe, effective ear wax removal.
Roger Stokes, one of our audiologists, who qualified in 1994, actually prefers to always look into patients’ ear canals using the endoscope as it gives a much clearer, detailed picture/video inside the ear canal than a traditional otoscope – particularly of the health and condition of the eardrums (tympanic membranes).
The beauty of this is being able to show the patient the inside of their canals using the iPod images and video recordings.
The procedure is usually performed with the patient seated comfortably, with the head tilted to the side, to facilitate easier access to the ear canal.
As the specialist can watch the procedure in detail via the iPod, it makes it much quicker, safer and more comfortable than ear syringing or ear irrigation.
Our Endoscopic microsuction sessions can take between 10-30 minutes. However, this can vary depending on the amount and type of wax, how deep it is and whether you are having one or both ears cleared.
Generally, it is not necessary to use ear drops to soften the wax for several weeks as often advised. However, we do usually recommend using Earol (olive oil spray), or Almond oil for 3-4 days prior to the wax removal appointment. If you are aware of an infection or a perforated eardrum, we do not advise using any drops at all.
No water is jetted into the ear canal at all – this is a “dry” procedure, therefore reducing the risk of infection or accidentally pushing the wax further down into the ear.
Endoscopic microsuction can be used even if your eardrum is perforated, or if you have a grommet inserted, a mastoid cavity or a cleft palate – conditions which should not have the water irrigation/syringing method!
Endoscopic wax removal was clinically found to be quicker, easier and more comfortable than microscopic microsuction in a clinical study¹ which compared the two methods.
It must be made clear that no method of wax removal is totally risk-free. There are some risks, which we detail to our patients when they arrive for their appointment. These can be as follows: possible trauma/damage to the eardrum (including perforation); a temporary or permanent hearing loss due to the sometimes loud noise in the canal; possible tinnitus or worsening of a pre-existing condition (although this is rare) and also possibly making the patient feel dizzy, faint or experience vertigo – this can be as a result of the process cooling the temperature inside the ear canal – although rare, it is usually short-lasting.
1 Potier D.D., Hall C. & Gillett S. (2006) A comparison of endoscopic and microscopic removal of wax: a randomised clinical trial. Clin. Otolaryngol. 31, 375-380
Created with the aid of Liberty Murray (Hear4U Health Care Assistant)
Unlike ear syringing, where water is used to flush the wax out without the use of a microscope, this method another method of ear wax removal using a microscope. The technique which is safe, comfortable and pain-free and can sometimes be more effective. With the Microsuction method, you don’t have to use olive oil prior to having the treatment, however, it may help but is not necessary.
Like with all ear wax removal procedures, upon your arrival, you will be greeted and asked to fill in a questionnaire in relation to your ear health history and any medication you may be taking.
You may also be asked for your consent to send a letter to your GP advising them of any treatment carried out. Your ear care specialist will then invite you into the treatment room, they will first make sure you are comfortable and then will explain what the procedure entails.
Firstly, the specialist will begin to examine your ear using a microscope to deter the consistency and extent of the earwax.
A microscope is used which provides the ear care specialist with a clear and magnified view of the ear canal. During the procedure a medical suction devise is used to suck out the wax, a piece of equipment which is made of very thin still is placed onto the suction tube which allows the ear care specialist to gently suck the out the earwax from the ear canal using the low-pressure suction devise.
A video otoscope will be used to show you a clear image of before and after the treatment. Microsuction is a dry procedure, with no liquids/water being used or flushed into the ear there will be no mess during this procedure. This also reduces the risk of infection. Microsuction is pain-free and quick, it is totally comfortable, and the blockage can be removed in minutes, it is also safe for people who have a perforated eardrum
Microsuction is accepted across the medical profession as the safest and most comfortable method of ear wax removal, however, no treatment of ear wax removal is completely risk-free.
As with all medical procedures, there can be problems, generally though these problems are quite rare.
The risks are as follows:
Microsuction is still considered to be safe, comfortable and with little or no risk when undertaken by an experienced and qualified professional.
Once the treatment is completed, and the procedure is successful, you will be free to leave the clinic, the best way to look after your ears after the appointment is to try to not use cotton buds, scratch or poke your ears. The ear canal naturally cleans itself and when you fiddle with the ears you are more likely to cause them problems such as a build-up of wax or worse an ear infection.
To clean the outside of the ear, use a dry tissue or an alcohol-free baby wipe to wipe around and behind the ear after taking a shower or bath.
Another way to prevent a build-up of ear wax using olive oil drops at least once a month, this will help soften and break the wax apart making it easier for it to move out of the ear canal.
if the wax is cleared but you still feel your experiencing hearing difficulties, the ear care specialist may recommend booking you in for a hearing test to test your hearing.
Many of you may have heard of the procedure Water Syringing, but the more modern term used now is Water Irrigation. Water Irrigation or syringing is a method of wax removal carried out by most Ear Care Specialists or clinicians usually using the Propulse water Irrigator. The Propulse Irrigator enables effective patient care, with adjustable water pressure providing safe water delivery.
Inside of the ear is very sensitive, if you have a build-up of ear wax this can cause damage to the canal and eardrum which can affect your hearing. The ear irrigation method is a safe way to minimize the risk of damage to the ear, however, ear syringing is not safe for everyone. Individuals who have severe Otitis Externa, also known as swimmers’ ear and those with a history of eardrum surgery, middle ear disease or radiation therapy to the ear. Your ear care specialist will discuss with you a safer alternative of ear wax removal such as Microsuction or manual removal.
You will be advised to use olive oil at least 3 days prior to the appointment to try and soften the ear wax, failure to do this may mean the ear care specialist may not be able to remove the wax effectively and you will be asked to come back for a 2nd or 3rd appointment.
Before any ear care professional performs water irrigation, they will ask you a series of questions based on your medical history to deem whether the procedure will be safe to carry out. Once they have all your information, they will then shine a light into your ears with an Otoscope which magnifies the image to ensure that your symptoms are the result of excess wax build-up and not something more serious.
Once you have been asked a series of questions, the specialist will you take you into the treatment room to begin the procedure. Using the controlled pressurised flow of water, they will begin to remove the build-up of ear wax. Under the gentle force of the water, the ear wax is softened and washed out of the ear. It’s important to know that cold water should not be used, instead be a warm, tepid temperature.
Water Irrigation is totally comfortable, and, in many cases, the ear wax blockage is removed in minutes, most people do not suffer pain during the procedure and often recommend it to their friends and family.
Like with most things you may experience some side effects from having the water irrigation method. These side effects are not typically serious, but they can be uncomfortable. Common side effects of ear irrigation can include the following:
The method of water syringing has come a long way, many GP surgeries unfortunately no longer offer this service, however, there are many Audiologists and Ear Care specialist up and down the country that are specialising in Water Irrigation and other methods of wax removal.
The benefits of water irrigation over the microsuction method is, it tends to remove the majority of the wax leaving a clear image of the eardrum. You wouldn’t necessarily get this outcome with the Microsuction method or Manual Removal alone. However, sometimes both Water Irrigation and Microsuction are used together to attempt to clear the ear.
You may experience some soreness after the procedure, this is extremely rare and can be due to the removal of large amounts of wax being removed. If you experience moderate to severe pain, this could be down to an undying infection, in this case, speak to your local pharmacist or make an appointment with your GP.
It is very important that you keep the ear dry for at least seven days after the procedure as you may be prone to infection, if you have a shower place some cotton wool into the ear and if you are a keen swimmer make sure to use earplugs.
If after having the procedure you find you are still struggling with your hearing, the ear care specialist will either advise on any medical issues detected and may provide a report for you to take to your GP or offer to book you in for a hearing test.
While earwax, also called cerumen, is a naturally occurring substance with health benefits, too much earwax can actually lead to hearing loss. Audiologists recommend that people clean their ears with a damp, warm washcloth daily, during a bath or shower. The ears should be dried thoroughly afterward.
Sometimes, additional ear cleaning is needed, especially when individuals produce too much earwax. When too much earwax is produced, it needs to be removed in order to prevent cerumen impaction.
Ear wax impaction is characterised by symptoms such as:
How Should I Clean My Ears?
To avoid these symptoms, it is important to follow safety protocols when cleaning your ears. Most cases of earwax blockage can be remedied using home treatments that soften the wax, but you should check with your hearing care professional to be sure.
The most effective at-home treatment is placing oil drops into the ear. Many household oils such as mineral oil, baby oil, and even olive oil can work to soften the hard, impacted earwax.
To use the oil, tilt the head to one side and insert five to 10 drops of oil into the affected ear. Hold the position for at least 10 minutes before bringing the head upright.
What If Oil Doesn’t Work?
If the earwax is persistent or multiple rounds of oil treatments do not help soften and remove the earwax, you may need to see a hearing healthcare provider for professional removal.
Hearing loss may become noticeable as you begin struggling to hear conversations with your loved ones in a busy restaurant or you need to turn up the TV to be able to listen to your favorite TV program clearly. Safety can also be an issue with hearing loss – Imagine if you don’t hear the car behind you when walking in a busy city or if you cannot hear the fire alarm in your house.
Ten million people in the UK – one in six of us – have some degree of hearing loss. We tend to see this as an inevitable part of aging, but there’s growing evidence of wider health implications. It can lead to social isolation, which in turn can contribute to mental health problems such as depression. Research suggests that it may be linked to an increased risk of developing dementia.
However, people in the UK suffer on average for 10 years before they seek treatment for hearing loss. One reason for this, is worrying about being given a large and obtrusive hearing aid, however modern varieties and the latest technology render this belief to be false.
Another reason many people don’t seek treatment, is failing to notice their hearing is declining. It can be tricky to spot gradual hearing loss, in part because our brains have a surprising way to compensate without us being aware, by relying more heavily on our vision. This is something we can use to our advantage, to help us cope with hearing loss.
Neuroscientists once thought that dedicated parts of the brain dealt with hearing and vision separately, and only later was the information from these two senses put together. Now scientists know that our brain is ‘cross-referencing’ information from our senses at an earlier stage than we thought. One of the ways this benefits us is by helping in situations that are difficult for hearing.
For instance, as we age, hearing what someone is saying in a noisy environment like a restaurant can become very challenging. However, our vision can provide our brain with extra information, such as mouth movements and gestures. This make it easier and requires less effort to pick a person’s voice out of background noise and discern what they are saying
The following factors contribute to age-related hearing loss:
When your brain is deprived of sound stimulation, it loses the ability to process sounds. The longer you wait, the more sounds disappear and it takes more time to re-adapt.
After you have a hearing test, your audiologist will review the hearing test results on an audiogram.
An audiogram is a graph that shows hearing sensitivity. The frequencies at the top of the graph are in Hertz (Hz). A frequency is often referred to as pitch. The higher the frequency the higher the pitch. The sound levels measured in decibels (dB) are located on the left side of the graph. Further down on the graph means an increase in intensity or loudness.
Your hearing levels in each ear are plotted on the graph to show the softest levels you can hear each pitch. The louder sounds are made to be heard, the greater the degree of hearing loss.
If you find yourself struggling to hear the TV, or in social situations continuously asking friends and family to repeat themselves, it may be time to book yourself in for a hearing test.
Hearing is one of our primary senses, providing us with the ability to learn about our surroundings, understand language, and to communicate with others, there is no shame in getting your hearing checked and you may find if you’re suffering from a hearing loss, hearing aids will improve your quality of life greatly.
The first step to take is to locate your local hearing specialist known as an Audiologist, who will be able to provide you with an appointment to check your hearing and advise you whether or not you have a hearing loss and if so what type and level loss you have.
A hearing test can last between 20 minutes and 60 minutes, you will be asked a series of questions, ranging from the type of communication difficulties you feel you are experiencing to your medical history, lifestyle and hobbies. This is so the hearing specialist can gain some insight into any possibilities to whether there may be a cause to your hearing loss rather than it just being age-related.
Before proceeding with the hearing test the Audiologist will check your ears to make sure your ears are clear of any wax if your ear is blocked the hearing specialist would firstly refer you or book you in for an appointment to have your ears cleaned using either the water irrigation method or microsuction.
If your ears are clear the hearing specialist will perform a test called audiometry, this involves you wearing headphones to which then sounds of different tones and volumes are played, you will be asked to press a button each time you hear a sound. The sounds that you hear will gradually become quieter to find the softest sounds that you can hear. A hearing test measures how well your brain receives sounds through the ear canal and the skull to determine the type of hearing loss you have.
After the hearing test is completed the results will be displayed on a chart called an audiogram. An audiogram is a graph that will show you the softest sounds a person can hear at different pitches and frequencies. Where your results fall on the audiogram will Indicate the different degrees of hearing loss.
If the results of the audiogram show that you have a hearing loss the hearing specialist will explain what type of hearing loss you have and whether it can be treated.
For individuals who suffer from severe hearing loss, hearing aids are the gold standard treatment, hearing aids vary in style from behind the ear (BTE’s) in the ear (ITE’s), or completely in the ear (CIC).
Your Audiologist will take you through the whole process, making sure you understand fully your results and treatment available. Should your hearing loss show that it’s not enough to warrant any further treatment you may be encouraged to return every twelve months to re-test your hearing.
Earwax removal can be a pretty scary thing when it’s your first time. However, most people don’t realise that it’s very common. It’s so common in fact, that it’s the most likely reason for temporary hearing loss. No need to be embarrassed as you’re not the only one having problems with earwax. It’s natural for there to be a build up from time to time. Below are the two types of earwax removal you will come across with the advantages and disadvantages as well as how to protect your ears.
Microsuction is a newer form of earwax removal and the preferred option. Not only do you not need to soften the wax using olive oil or ear drops in most cases, it doesn’t leave the ear waterlogged after the procedure. In addition, it is less likely to cause an ear infection as can happen sometimes with irrigation. Microsuction earwax removal works by placing what might as well be a vacuum cleaner into the ear. This then sucks the earwax out. Some clinics will have camera on the end of the Microsuction device with a television screen so you can see the earwax as it’s being removed.
Irrigation involves pumping water into the ear and holding a pan on the neck of the patient till all the wax gets flushed out. The downside to irrigation is that you usually have to spend a couple of weeks softening the wax with olive oil or ear drops. If you’re looking to have the wax removed same day, irrigation isn’t convenient. Irrigation also leaves your ears vulnerable to infection as they can become waterlogged (otitis externa).