There are a number of professional earwax buildup removal procedures - for example oto irrigation, syringing, ear wax buildup microsuction, aural earwax micro suction, aural toilet, and dry instrument removal.
Aural toilet is an unusual sounding term for ear wax removal. In this instance, toilet doesn't refer to a water closet but rather is an antiquated medical term for cleaning. It is more commonly known as dry instrument removal - under illumination the professional uses a variety of Jobson Horne Probe Ear Curettes. These come in different shapes and sizes and collectively known as wax hooks. Dry instrument removal is generally safe, but the main concern is that with a complete ear wax blockage, it is not possible to see what lies behind the blockage and there is a small possibility of pushing hard wax against the eardrum. Dry Instrument Removal is sometimes recommended for those who are over sensitive to loud noises.
Ear syringing is commonly carried out by GP Practice Nurses. Originally, a large metal syringe with a long metal probe was used. The syringe was filled with warm water, and the nurse would insert the probe into the ear canal and use their judgement how much pressure to use when squirting the water into the ear. This has largely been replaced due to the potential complications of unregulated water pressure and a large metal probe going in the ear. The equipment now used is a water pump with a flexible water jet. This is safer than the old metal ear syringe, but still has potential complications. There may be a perforation of the ear drum that cannot be seen because of the wax blockage. In this case, some wax, skin and bacteria may be washed through the perforation into the middle ear, with the potential of a severe middle ear infection. Less serious, but sometimes distressing for the patient is when the water jet is aimed off target and the wax is pushed deeper into the ear canal. When ear syringing goes wrong, or when it can't remove all the wax, patients are often referred for aural microsuction.
Aural Micro Suction is in our opinion the gold standard of professional ear wax removal procedures. Patients are often referred for micro suction when other procedures fail to remove all of the wax. Microsuction can be performed by an ENT (Ear Nose and Throat) Surgeon, also known as an Otolaryngologist, or Otologist, or a trained GP, Nurse or Audiologist. The equipment required for suction of the ear is a suction pump, a collection cannister, a suction hose and suction wand. The micro part is a stereo microscope, either a floor standing unit, or more portable ones called surgical loupes - a bright light source is normally attached - together these enable the professional to clearly see what is happening inside the ear canal during the procedure. Unlike syringing, which introduces water into the ear, micro suction introduces nothing into the ear - it only removes wax from the ear.
Patients will hear the rushing sound of air going into the suction wand - and also a popping sound as the ear wax is suctioned down the wand, through the suction tube into the collection cannister. Sometimes if the wax is stringy it might make a squeaking sound. Readers may find it reassuring that the noise levels within the ear canal during microsuction have been measured and are deemed to be safe.
In most cases, microsuction will remove all the wax, but sometimes the wax is so deep inside the ear canal and/or so impacted that the professional will decide that it is necessary to apply cerumenolytics for another week before a second appointment. This is because sometimes the wax in the outer part of the ear canal will be soft, but the ear drops were not able to penetrate deep into the canal, so the wax that is further in is still too hard and firmly attached.
Compared to any other method of professional ear wax removal, aural microsuction is considered to be the safest and most effective procedure.
For a reliable professional ear wax removal clinic, we suggest the Earwax Removal Clinic Network.