`	Grwp Meddygol 
Ystwyth 
Medical Group 

	                             	Parc y Llyn
Aberystwyth
Ceredigion
SY23 3TL

Tel: 01970 613500
Fax: 01970 613505	

Ear Syringing Advice

Why we no longer syringe ears

Ear Nose and Throat (ENT) consultants have advised the best treatment for wax that is causing deafness and it is our intention at the surgery to follow their recommendation.

Syringing is now considered an outmoded method of removing wax that has associated hazards, such as the risk of perforation the ear drum, tinnitus, dizziness or infection both in the ear canal and deeper in the ear.

Wax (cerumen) is a normal secretion from the glands inside the ear canal. We all produce wax in various amounts, some people produce excessive amounts which can lead to blockage in the ear canal. The wax works as a protective layer from the delicate skin inside the ear canal. It normally removes itself by shedding in small flakes or crusts.

A doctor or a nurse can look into the ear canal and confirm a plug of earwax has formed. A plug of earwax is not a serious problem, more a nuisance. Ear wax becomes a problem if it causes deafness, discomfort, or if your health professional requires a clear view of your ear drum. If you experience pain, or blood stained/smelly discharge please arrange to see a GP.

Why is my ear blocked with wax?

You are more likely to develop blockage of wax in the canal if you:

-	Use cotton ear buds to clean the ear as this pushes the wax deeper into the canal.
-	Wear a hearing aid, or ear plugs or use in-ear speakers for i-pods or similar – as these can interfere with the natural process of wax expulsion.
-	Have abnormally narrow or particularly hair ear canals.
-	Are elderly – because the wax you produce is drier and harder.
-	Have a dry skin problem such as eczema or psoriasis.

Preferred methods of dealing with ear wax are (in order of preference):-

Step 1

Leave well alone if you are not getting any symptoms as ears are designed to naturally clear their own wax. Do not insert anything in the ear. Cotton buds, matchsticks, and hairpins can:

-	Damage the wall of the canal and increase the likelihood of otitis externa.
-	Cause the wax to become impacted by pushing it further into the canal.
-	Perforate the tympanic membrane.

Step 2

The use of a softening agent such as olive oil to help wax disperse and prevent ear blockage.

What Drops Should You Use?

There are a variety of drops available at your local chemist however; some may cause irritation on regular use. Speak to your pharmacist first about the most suitable product for you and make sure you read the leaflet that comes with it.

Olive oil (as used in the kitchen) is as effective as any you can buy and does not generally cause any irritation or soreness.

For the oil to be administered in the correct place it should be applied via a special dropper which can be purchased from the chemist, otherwise the end of a teaspoon can be used.

It is more effective if you can ask a partner/friend/carer to apply the drops to the affected ear, as it is really important the drops end up in the lower part of the ear canal and not on the ledge of the entrance to the ear.

Use oil at room temperature. Pour 2 or 3 drops into the affected ear. Lie with the affected ear uppermost when putting in the drops. Stay like this for 2-3 minutes to allow the drops to soak into the earwax.

Do not apply cotton wool as a plug after oiling as this will absorb the oil making the process less effective.

Continue to put drops into the affective ear 2-3 times a day for up to 21 days and the ear wax should soften and disperse naturally.

Step 3

Micro-suctioning – using a small suction device under direct observation to physically remove the wax as it carries less risk of perforation, damage and infection compared to ear syringing. This is a safer means of clearing wax from the canal.

Micro-suctioning on the NHS is only available for patients with certain ear condition such as previous ear drum surgery or mastoid cavities.

Private micro-suction is available at local private hospitals provided by ENT consultants. Alternatively by High Street companies which can be found by searching for “ear wax removal Wales” in Google. As a surgery we are unable to recommend anyone in particular.