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Earwax - Management
How should earwax be removed?
- Prescribe ear drops for 3–5 days initially, to soften wax and aid removal.
- Sodium bicarbonate 5%, sodium chloride 0.9%, olive oil, or almond oil drops can be used.
- Sodium chloride 0.9% is not available as a proprietary ear drop product. However, sodium chloride 0.9% nasal drops can be prescribed for use in the ear (off-label use).
- Do not prescribe drops if you suspect the person has a perforated tympanic membrane.
- If symptoms persist, consider ear irrigation, providing that there are no contraindications.
- 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 an Ear Nose and Throat specialist for removal of wax.
- Advise anyone who has had earwax removed to return if they develop otalgia, or significant itching of the ear, discharge from the ear (otorrhoea) or swelling of the external auditory meatus, as this may indicate infection.
In depth
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