Frequently asked questions

Is wax a problem?

There are various theories as to why we produce ear wax. It's generally thought that it its our body's way of keeping the ear canal clean, with the canal slowly producing wax that naturally moves out of the canal with time. It can become a problem when too much is produced and builds up. This can cause reduced hearing and an uncomfortable feeling of the ear being blocked.

What about ear syringing?

Ear syringing is a method that involves introducing water into the ear canal. It is no longer recommended for earwax removal as it can cause infection and trauma to the ear canal. Microsuction is the 'Gold Standard' treatment for ear wax as recommended by the National Institute of Clinical Excellence (NICE).

What can I do to treat the wax myself?

We recommend using olive oil or sodium bicarbonate drops to the ears one or twice a day for a week. Sometimes this is enough to help your symptoms. Other times there is so much wax build up that microsuction is required to remove it. Use of cotton buds or tools to remove wax tend to only push it deeper and cause impactaction, making things worse! Using drops prior to your appointment softens the wax and makes microsuction more effective.

What is microsuction?

'Micro' refers to the microscope that we use. We use a surgical grade microscope that gives us a high definition view of your ear canal. 'Suction' refers to the suction tube tip that we place inside the ear canal to suction out the wax. We do this while you are lying on your back with your head on a pillow.

Is there anything I should do before my appointment?

We recommend using olive oil or sodium bicarbonate drops for a few days prior to your appointment, this helps to soften wax, making microsuction more effective. However microsuction can also be performed without any prior drops.

When should I see my GP?

While we are experienced healthcare professionals, Grove Ear Clinic is limited to treating ear wax. If you are experiencing new ear symptoms such as pain, discharge or tinnitus, or suspect you have an infection, we recommend seeing your GP. Sometimes it can be difficult to know if wax is the problem, we can offer consultation and endoscopic ear imaging to confirm if there is wax before proceeding with microsuction.

Do you see children?

We are happy to see children. In our experience children are very variable with how well they tolerate microsuction, some find the sensation and noise in their ear difficult to manage. We will work with you and your child to make it a positive experience and to keep them comfortable throughout. Unfortunately there will be times where full wax removal is not possible and we will discuss the next steps you can take if this is the case.

What are the risks of microsuction?

Microsuction is generally very safe and well tolerated. It is the most widely used method of earwax removal by professionals and is generally regarded as the safest method of earwax removal.

The British Society of Otology have recently published new guidelines regarding microsuction. They quote the following risks;

Trauma to the ear canal skin (1 in 20). This will be associated with more severe pain than expected or bleeding from the ear canal. Both usually settle within a few seconds or minutes once microsuction is stopped.
Trauma to the ear drum (<1 in 10000). This will be associated with more severe pain than expected and may result in bleeding, hearing loss, vertigo or tinnitus (see below).
Ear canal infection as a sequelae to trauma (1 in 500). A secondary infection can develop after a traumatic microsuction
Severe vertigo (1 in 200). This can very occasionally occur in patients that have a canal wall down mastoid cavity but may also result from trauma to the ear, especially trauma to the ear drum which in the most severe cases can be associated with disruption to the ossicular chain
Temporary (1 in 100) or permanent tinnitus (1 in 5000). It is unusual to experience tinnitus following uncomplicated microsuction but some patients who are particularly sensitive to noise may develop tinnitus. This is usually temporary and may be associated with a temporary threshold shift. There are very rare cases in which permanent tinnitus is described.
Temporary (1 in 1000) or permanent conductive hearing loss (<1 in 10000). This is rare but can result from further impaction of debris in the ear canal in the difficult to clear ear, from blood that has built up as a result of trauma to the ear canal or from trauma to the ear drum or, in extreme cases, to the ossicular chain. Most conductive hearing losses are temporary.
Temporary sensorineural hearing loss (temporary threshold shift)(1 in 100). The intensity of the sound from microsuction can, in sensitive patients, result in a temporary threshold shift. This usually lasts a few minutes but can last a few hours.
Permanent sensorineural hearing loss (permanent threshold shift)(<1 in 10000). It is extremely rare to develop permanent sensorineural hearing loss as a result of microsuction but there are very sporadic reports in the literature of this resulting from the noise generated by microsuction. It can also occur from severe traumatic injury to the ear drum and ossicular chain.

The full clinical guidelines can be found at;

https://www.entuk.org/resources/207/clinical_guidance_on_microsuction_of_the_external_ear_canal