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Earwax - Management
Overview of management
- Indications for removal of earwax include:
- Totally occlusive wax.
- Symptoms presumed to be due to wax.
- Diagnostic purposes, to gain an unimpeded view of the tympanic membrane.
- If the person wears a hearing aid and there is wax present and an impression needs to be taken of the ear canal for a mould, or if wax is causing the hearing aid to whistle.
- Explain that removal of earwax may not necessarily relieve the symptoms.
- Prescribe ear drops for 3–5 days initially, to soften wax and aid removal (unless the person has a perforated tympanic membrane).
- If symptoms persist, consider ear irrigation, providing there are no contraindications and you are still confident that symptoms are due to earwax.
- If irrigation is unsuccessful, there are three options:
- Advise the person to use ear drops for a further 3–5 days and then return for further irrigation.
- Instill water into the ear. After 15 minutes irrigate the ear again.
- Refer to secondary care for removal of wax.
- Refer to secondary care anyone in whom the above treatment is contraindicated or is unsuccessful.
- Seek immediate advice from an Ear Nose and Throat specialist if severe pain, deafness, or vertigo occurs during or after irrigation, or if a perforation is seen following the procedure.
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