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Earwax - Management
When should earwax be removed?
- Consider removing earwax if:
- Earwax is totally occluding the ear canal and any of the following are present:
- Hearing loss
- Earache
- Tinnitus
- Vertigo
- Cough suspected to be due to earwax
- The tympanic membrane is obscured by wax but must be viewed to establish a diagnosis.
- The person wears a hearing aid and needs a mould or the wax is causing the hearing aid to whistle.
Basis for recommendation
- There is no evidence to suggest when earwax should be removed, and the basis for this recommendation is expert opinion [Sharp et al, 1990; Browning, 1994; Aung and Mulley, 2002; Guest et al, 2004; NHS Quality Improvement Scotland, 2006; Action on ENT Steering Board, 2007].
- If there is hearing loss and the tympanic membrane cannot be seen, then the wax should be removed as the majority of causes of conductive deafness are diagnosed by examining the tympanic membrane [Browning, 1994].
- Once the wax has been removed if hearing does not improve then alternative causes should be considered [Browning, 1994]. Visualisation of the tympanic membrane may identify causes of conductive deafness.
- Wax may need to be removed in order to take an impression of the ear canal, for people who wear hearing aids. Excess wax may cause the hearing aid to whistle.
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