Ear Microsuction vs. Other Ear Wax Removal Methods
What Is Ear Microsuction?
Ear microsuction is an ear wax removal technique that uses either an ENT (Ear Nose and Throat) binocular operating microscope or specialised magnification loupes (similar to the type dentists use).
This technique allows the clinician to look in the ear canal in great detail and use a very fine sterile suction device at low pressure to remove the wax.
This process of ear wax removal is a little bit like using a tiny vacuum cleaner inside the ear to remove the wax.
If the wax is particularly hard, we may need to use other instruments as part of the ear microsuction procedure, such as Jobson Horne probes, mini hooks, or micro forceps.
Microsuction vs Ear Syringing
Ear microsuction has been repeatedly shown to be superior to other methods of ear wax removal, such as syringing, irrigation, aural toilet, and ear drops. Ear microsuction is regarded as the gold standard technique for ear wax removal, as well as treating ear infections.
Using ear microsuction means that we can visualise the external ear canal and its contents in great detail while having minimal physical contact with the ear canal wall, which makes for a more comfortable ear wax removal procedure. Ear microsuction is therefore:
- Safer
- Faster
- Better tolerated
- More effective
What's more, it typically doesn't require weeks of waiting for ear drops to soften the wax before it can be removed. Ear microsuction may even be performed on the same day you decide to book an appointment.
What Do Other Ear Wax Removal Methods Involve?
Ear syringing, which is sometimes referred to as ear irrigation, is the default method of ear wax removal in many GP surgeries. This procedure involves using a pressurised flow of water to remove a build-up of ear wax.
If you’re comparing microsuction vs ear syringing, bear in mind that syringing or irrigation is not as effective as ear microsuction in many cases. What’s more, microsuction doesn’t require the use of ear drops to soften wax prior to the procedure being carried out.
In addition, ear syringing/irrigation is associated with a much higher risk of perforating the ear drum - this occurs in up to 5% of cases compared to less than 0.1% with microsuction.
Aural toilet is a method of ear wax removal that involves an instrument known as a Jobson Horne probe. This is a thin metal or plastic instrument with a small ring at one end that the specialist can use to remove ear wax from the ear canal.
Ear drops can be used to soften and loosen ear wax, but not to remove it. Ear drops should not be used if you have a perforated eardrum.
Ear drops vary in composition, with olive oil, sodium bicarbonate, and hydrogen peroxide-based drops available in many pharmacies.
Using olive oil to soften ear wax is generally completely harmless, but sodium bicarbonate and hydrogen peroxide-based drops can be irritating to the ear canal so must not be used for prolonged periods. If you have a perforated ear drum, using sodium bicarbonate or hydrogen peroxide drops is extremely painful.
Ear microsuction can be carried out without the need for ear drops to soften wax beforehand. However, drops are usually necessary prior to ear syringing or ear irrigation.
During the ear microsuction procedure, aural toilet is sometimes required if particularly hard ear wax needs to be removed.
Treating Ear Wax Build-up: What You Need To Know
In most cases, ear wax will fall out of the ear on its own, so there is no need for an ear wax removal procedure. However, if there is an ear wax build-up that is completely blocking the ear canal and is causing hearing loss or discomfort, it may need to be removed.
Ear wax removal may be necessary in the following instances:
- When there is difficulty in examining the full tympanic membrane (ear drum)
- Otitis externa - an external ear canal infection
- In the event of wax occlusion of the external ear canal
- As part of the work-up for conductive hearing loss/hearing tests
- Prior to taking an ear impression for hearing aid fitting
- If there is suspected external ear canal or middle ear cholesteatoma
- As part of grommet insertion or middle ear surgery
- At the patient’s request
Get in touch with the Ear Care Clinic team if you have any questions.
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