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Earwax - Management
What are the contraindications, cautions and warnings for ear irrigation?

  • Do not use ear irrigation to remove wax for people with:
    • A history of any previous problem with irrigation (pain, perforation, severe vertigo).
    • Current perforation of the tympanic membrane.
    • A history of perforation of the tympanic membrane in the last 12 months. Not all experts would agree with this: some experts would advise that any history of a perforation at any time, even one that has been surgically repaired, is a contraindication to irrigation because a healed perforation may have a thin area which would be more prone to re-perforation.
    • Grommets in place.
    • A history of any ear surgery (except extruded grommets within the last 18 months, and the person has been discharged from the Ear Nose and Throat department).
    • A mucus discharge from the ear (which may indicate an undiagnosed perforation) within the past 12 months.
    • A history of a middle ear infection in the previous 6 weeks.
    • Cleft palate, whether repaired or not.
    • Acute otitis externa with an oedematous ear canal and painful pinna.
    • Presence of a foreign body, including vegetable matter, in the ear.
    • Hearing ear in only one ear if it is the ear to be treated, as there is a remote chance that irrigation could cause permanent deafness.
    • Confusion or agitation, as they may be unable to sit still.
    • Inability to co-operate e.g. young children and some people with learning disabilities.
  • Use ear irrigation with caution in people with:
  • Warn people with a history of recurrent otitis externa or tinnitus that ear irrigation may aggravate their symptoms [Burton and Doree, 2003].

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