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Thinking of getting your ears syringed?

Here’s why experts say you should think again – and what to do instead.

Blocked ears due to ear wax build up can be extremely annoying, and can cause hearing loss, tinnitus and ear pain.

When looking for a solution, many turn to their GP for ear syringing, also referred to as ear irrigation, but a lot of doctors are no longer providing this service amid growing evidence about the risks.

A quick and safe microsuction technique traditionally performed by ENTs is now more readily available in the community and is emerging as a popular alternative to syringing.

What is ear syringing?

Ear syringing involves squirting a stream of water in the ear canal in an attempt to flush out the wax. There are several risks with this method, including the increased risk of infection due to water in the ear. Other risks include the potential for water to be pushed back into the ear canal, resulting in pain and no resolution to the problem, dizziness or nausea caused by water which is not at body temperature, and a risk of perforation to the ear drum if the water is not administered properly.

One in five medico-legal cases involving GPs are related to ear syringing, and one out of 1000 patients who undergo this technique experience major complications (1). As a result, many GPs no longer offer the service. In the UK, the NHS no longer funds ear syringing through the public health system.

The benefits of microsuction

Microsuction has emerged as a safe, quick, well-tolerated and effective alternative to ear syringing. Until recently microsuction was only available through ENT outpatient clinics, which had long wait lists, but it is now widely available in the community via audiologists. This has created an added benefit of reducing pressure on the overloaded GP and public health system.

Preliminary evidence from the British Journal of Clinical Pharmacology suggests microsuction offers fewer risks compared to ear syringing. The treatment is performed under magnified vision with a microsuction machine, which features a suction tip that gently draws the wax out of the ear and into the machine. In cases when the wax is closer to the entrance of the ear canal, curettage is used instead.

The service is quick, usually taking around 15 minutes, and does not expose the ear canal to moisture in the way ear syringing does. In some cases, patients will be given wax softening drops first.

A study (2) in 2014 found the procedure to be successful in 91 per cent of cases.

Studies suggest increased access to microsuction in the community will have positive flow on effects in the health system.

The more accessible such treatments can be made, the more equitable the service becomes with regard to disadvantaged patient groups,” a study by the British Journal of General Practice concluded (3).

“Community-based services have the potential to do this, as well as of reducing the burden on secondary care services”.

What experts agree on is people suffering from impacted ear wax should not attempt to remove the wax themselves, as this can cause damage to the ear.

1. Sharp JF, Wilson JA, Ross L, Barr-Hamilton RM. Ear wax removal: a survey of current practice. BMJ 1990; 301(6763): 1251–1253.

DOI: https:// doi. org/ 10. 1136/ bmj. 301. 6763. 1251

2. Prowse SJ, Mulla O. Aural microsuction for wax impaction: survey of efficacy and patient perception. J Laryngol. Otol 2014; 128(7): 621–625.

DOI: https:// doi. org/ 10. 1017/ S0022215114000796


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