EAR IRRIGATION
Earwax is produced inside your ears to keep them clean and free of germs.
What to do you if you think your ear is blocked:
Don’t try to remove a build-up of earwax yourself with your fingers, a cotton bud or any other object. This can damage your ear and push the wax further down.
If the earwax is only causing minor problems, you can try buying some eardrops from a pharmacy. These can help soften the earwax so it falls out naturally, and must be used for a minimum of 14 days.
Preventing ear wax build –up
Some people are naturally prone to ear wax building up in their ears and may need frequent treatment to remove it when it becomes a problem.
It’s not clear if there’s anything you can do stop earwax blocking your ears, although some doctors recommend the use of eardrops regularly to keep your ear wax soft.
Ear syringing is not recommended and only used as a last resort after minimum 2 weeks of eardrops to soften the wax.
What are the complications of ear irrigation?
- Failure of wax removal.
- Otitis externa.
- Perforation of the tympanic membrane.
- Damage to the external auditory meatus.
- Pain.
- Vertigo.
- Otitis media due to water entering the middle ear when there is previous perforation.
- Exacerbation of pre – existing tinnitus.
- Serious injury to the middle and inner ear (rare).
- Bleeding (usually self limiting).
- Nausea, vomiting and vertigo may result from temperature variations of the irrigating fluid.(NICE CKS, 2016)
PATIENT ADVICE
Treatment of Ear Wax
Ear wax is normal and has many functions including protecting the ear drum from foreign bodies, moisturising and lubricating the ear canal, trapping dust, micro-organism and other debris, and cleansing the ear canal. It also has antibiotic, antibacterial and antifungal properties. In short ear wax is wonderful!
Ears are self-cleaning; they should not be prodded with cotton buds. Ear wax which is produced will gradually find its own way out of the canal where it can be removed with a tissue. Occasionally ear wax can become dry and a build up can occur, causing temporary impairment of hearing. In this instance, the safest and first line approach is oiling of the ear.
The following instruction should be adopted when oiling ears to soften wax build up:
- Lie flat on your side with the affected ear uppermost
- Pulling back the ear just above the fleshy part, insert 2-3 drops of Almond or Olive oil into the ear canal. Droppers can be purchased from local pharmacies. Oil should be at room temperature and should not be heated.
- Remain lying in this position for 15 minutes to allow the oil to work.
- During this time, massage the area in front of the affected ear to spread the oil around inside.
- After 15 minutes, sit up and tissue away any excess oil.
- Do not insert cotton buds or cotton wool into the canal as this may push wax further inside, damaging the lining of the ear canal or the eardrum.
- Repeat the process on the other ear as required
Ears should be oiled in the way TWICE DAILY FOR 2 WEEKS. If your ears continue to feel blocked or your hearing is impaired, please arrange an appointment with the ANP for an ear assessment. The ANP may then advise you to continue with the oiling process as required. Occasionally, the ANP may advise that ear irrigation is required.
Ear irrigation is not a first line treatment for ear wax. It can result in serious complications including
- Perforation of the ear drum, infection of the outer ear or inner ear pain, acute or recurrent vertigo, tinnitus and loss of hearing.
- Patients, who have been advised by audiology departments to have ear assessment prior to attendance at a clinic, may be advised by the ANP to reschedule their clinic appointment if their ears are blocked with wax, to allow time for safe removal of ear wax.