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microsuction for ear wax removal

What is microsuction ear wax removal?

As the name suggests, microsuction traditionally was a method of ear wax removal that made use of a microscope to give a clear visual of the ear and a suctioning machine to remove the wax. With new advances in technology, large microscopes can be replaced by small adaptions to our phones or head loupes, which allow the practitioner to perform the procedure more easily.​

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The difference between microsuction and ear syringing

Think of the suction machine as a small vacuum. It has a variable pressure setting, which allows the practitioner to control the amount of suction the device is using. When working close to the eardrum, experience is vital, as it requires skill and knowledge to be able to adjust the suction strength to the right level, which is both safe for your ear, and effective at removing the wax.

A much more familiar method of ear wax removal is water irrigation or syringing, as it is commonly known. This method was widely used by GP nurses in home settings. A jet of water was sent into the ear and the returning water was expected to remove the wax and get collected into a container held by the ear lobe. This can also make the procedure quite messy.

 

Risks with syringing​​​​

 

Certain risks have been raised with water irrigation which means it is no longer a recommended procedure for ear wax removal. The risks include;

o   Perforations of the eardrum- There is a greater chance of perforating the eardrum (making a whole). Certain eardrums are very sensitive and fragile, and too much water pressure can cause them to rupture. Water can also push wax against the drum, or can get trapped behind the wax leading to the same outcome.

o   Infections- Otitis external is an outer ear infection which can be quite painful. Water can irritate the delicate skin of the ear canal leading it to become infected.

o   Dizziness and vertigo- Slight temperature differences between the water and inner ear can lead to the caloric effect, which is a feeling of movement (vertigo).

o   Previous surgery- If people have had previous surgery to the ear drum which may have left the drums wakened or with a tube for ventilation, water irrigation is not suitable.

o   Stubborn Wax and Complicated cases- In straightforward, light wax cases, water irrigation can be quite effective. In cases with stubborn hard wax, which is impacted, the method is less effective, this is because the water needs a passage to get behind the wax to remove it on the way back. In cases where wax is impacted, this isn't possible, and the wax simply gets pushed further against the ear drum.

Is microsuction ear wax removal safe?

There are minimal risks associated with microsuction, as long as the procedure is completed by a qualified and experienced professional- more about this later. Unlike water irrigation, the air pressure can be controlled which makes perforations very unlikely. It is usually a very quick, gentle procedure, which is much more effective than water irrigation, especially in the more complicated cases.

In our ear wax removal clinics, you will be given all the relevant information to give informed consent before the procedure.

Does ear wax microsuction hurt?

While micro-suction is usually quick, and comfortable, there are a few things to consider. Firstly, our ears are very delicate and sensitive, especially the inner two-thirds closest to the ear drum. The first third which includes the ear itself is cartilaginous, which is quite flexible and tough. The skin beyond this though is wafer thin- only 0.5 mm surrounding bone. In most cases of impacted wax, the wax is sitting close to or on the ear drum. This can feel very uncomfortable and will impact your hearing.

This is why it is so essential to have any treatments on your ears completed by an experienced and qualified professional. In our opinion, this should ideally be an Audiologist, ENT doctor or at least an experienced ENT nurse who has lots of experience with ears. Recently other health professionals, like pharmacists are also able to complete short courses and provide the service, but we don't feel this is a wise decision, as they simply lack the experience and knowledge required.

Do you need to soften ear wax before microsuction?

Unlike water irrigation, there isn't a massive need to use lots of oil ear drops beforehand. While it is helpful to have done this for a few days, often too much oil can cause issues, in blocking up the suction equipment. Our advice is to use Otex ear drops, as the combination of hydrogen peroxide and olive oil seems to work best. This should be done 2-3 days before your appointment. In many cases, however, simply spraying oil during the appointment is sufficient to remove the wax if this wasn't possible beforehand, in emergency cases.

What about Children?

While the procedure is the same regardless of age, one needs to keep in mind that the patient must be very still throughout. It is recommended therefore that children below the age of approximately 6 years old do not have this done. Each case is to be assessed however on its merit, and in younger children than 6, when the parent assures us, they would be able to comply with the procedure, micro-suction is possible. Our CEO, Nasir Rashid, personally completes all children and adults with special needs.

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