Blog,Hearing Health

Understanding Ear Wax Removal

Ear wax, known medically as cerumen, is a normal and important part of a healthy ear canal. Produced by glands in the outer part of the ear canal, ear wax helps protect against damage and infection by trapping dirt, dust, and other debris. It also has antibacterial properties and contains oils that lubricate the ear canal.

While some ear wax buildup is normal, an excess amount can lead to problems like earache, feeling of fullness, ringing or buzzing in the ear, coughing, and even temporary hearing loss. If you’re experiencing these symptoms, it may be time to consider getting your ears cleaned by a medical professional. In this article, we’ll discuss when ear wax removal is recommended, what the process involves, and how to prevent excessive buildup.

When Ear Wax Removal May Be Necessary

Some symptoms that indicate a need for professional ear wax removal include:

  • Noticeable hearing loss or muffled hearing
  • Feeling like the ear is plugged or full
  • Ringing, buzzing, or itching in one or both ears
  • Coughing or gagging from ear fullness pressing on the eustachian tubes
  • Pain or discomfort in the ear
  • Frequent ear infections
  • Dizziness or balance problems

If you are experiencing any of these symptoms, making an appointment with your doctor or an audiologist is recommended. They can properly examine your ears and determine if excess wax is the cause.

It’s also best to get your ears cleaned professionally if you have worn hearing aids for some time, as the devices tend to push ear wax deeper into the canal. People who use earplugs regularly may also be at higher risk for blockage and could benefit from periodic cleaning. Elderly individuals should monitor for excess buildup as ear wax thickens with age.

Some signs that you should not attempt do-it-yourself ear wax removal at home include severe pain, discharge or bleeding from the ear, or a feeling of foreign objects lodged deep in the canal. These symptoms warrant seeing a medical professional promptly.

The Ear Wax Removal Process

There are several techniques audiologists and doctors use to remove excess ear wax, including:

Irrigation: This involves using a rubber bulb syringe or electronic irrigator to flush the ear with warm water, saline solution, or a special wax-softening liquid. The flushing helps dislodge and wash out the built-up wax.

Manual Removal: For more stubborn wax blockages, a curette (small scoop) or other specialized tool may be used to gently dislodge and pull out the wax. This is done carefully under a microscope to avoid damaging the ear canal.

Cerumenolytic Agents: These wax-dissolving solutions such as carbamide peroxide are eardrops that can be used for several days leading up to the procedure to soften and break up the ear wax. This makes removal easier.

To start the ear wax removal process, the audiologist will use an otoscope to look inside your ears and assess the blockage. They may ask you about symptoms and discuss your medical history. If using irrigation, the ear will be filled with water which is then flushed out repeatedly, sloughing off the excess wax inside the canal. This warm water can feel quite pleasant.

With manual extraction, the provider will use specialized micro-instruments to directly engage and remove the wax. Though this can sometimes cause brief discomfort, it is very effective for stubborn blockages. If eardrops are prescribed first to soften wax, you’ll administer them at home for several days then return to have the ear irrigated or manually emptied.

Throughout the procedure, the provider will give instructions on holding your head to keep the ear facing downward. This allows the water or dislodged wax to flow out. The full appointment typically takes around 30 minutes, with the actual irrigation or manual removal lasting only a few minutes once preparation is complete.

Afterwards, your ear will be dried thoroughly and you may be given additional drying ear drops to use at home over the next few days. It’s normal for the ear to have some residual watery discharge mixed with wax for 24-48 hours following irrigation. You may be advised to use an ear plug or cotton in the opening overnight to prevent this wetness from dampening your pillow.

Pros and Cons of Different Removal Methods

There are advantages and disadvantages to each approach for ear wax removal:

Irrigation Pros:

  • Considered safest method with minimal risk
  • Least invasive and most comfortable option
  • Requires no specialized tools inserted in the ear

Irrigation Cons:

  • Multiple appointments may be needed for severe buildup
  • Not recommended for people with ear tube implants or perforated ear drums
  • Can push some wax deeper into ear initially before flushing clear

Manual Removal Pros:

  • Most effective for removing stubborn, hardened wax
  • Usually successful in one appointment

Manual Removal Cons:

  • Slightly higher risk of minor injury or discomfort
  • Should only be done by a medical professional
  • Not appropriate for sensitive ears or children

Cerumenolytics Pros:

  • Help soften wax between appointments, improving results
  • Option for patients who can’t undergo irrigation

Cerumenolytics Cons:

  • Can cause minor skin irritation in ear canal
  • Requires return visit(s) to complete removal
  • Not as effective alone for dense, dry wax

In general, irrigation is suited for most cases of excessive ear wax, while manual removal works better for dense or hardened blockages. Cerumenolytics act as a helpful preparatory step but don’t remove wax on their own. Your provider can recommend the best method based on your specific situation.

Aftercare and Preventing Buildup

After having your ears cleaned, avoid inserting anything including cotton swabs into the ear canal for several days. This allows the skin to heal and lessens the chance of pushing newly loosened wax deeper inside. Keep water out of the ear when bathing for at least 2-3 days.

Over-the-counter wax softening drops can be used periodically to help prevent excessive impaction. If your ears seem prone to amassing wax, request a schedule of follow-up visits every 6 to 12 months for cleaning and monitoring.

See your doctor promptly if symptoms like hearing changes, pain, or discharge return after the procedure. Any bleeding, worsened tinnitus, or intense vertigo following ear wax removal should be evaluated right away. With proper aftercare, most patients experience improved comfort and hearing.

In conclusion, while a little ear wax is normal, excessive buildup can negatively impact your hearing and comfort. Visiting an audiologist for wax removal is quick, effective, and painless when needed. The best approach can be determined based on the amount and condition of the ear wax. With routine cleaning as necessary, potential hearing problems related to blockages can be avoided. Our clinic is always available to assess your ears and discuss the options. Please reach out with any questions.

About the Author

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Ben Horlock Audiologist

Ben Horlock RHAD MHSAA, is an accomplished audiologist deeply committed to delivering remarkable audiological services.

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