Your experience begins with a brief phone conversation during which we will ask a few basic medical questions. We will then advise you on the use of medical grade olive oil to soften your earwax. This makes it significantly more likely we will remove your wax in one appointment and more likely we will do so without causing discomfort. We strongly recommend the use of the 'Earol' brand olive oil spray that can be purchased in any high street chemist. Our recommended pre-treatment is three measured spray doses in each ear, three times a day for three days prior to your appointment.
Please do not put oil drops in your ear if you have a perforation of the ear drum, if you have a known ear infection or dermatitis within the ear canal. In addition do not use if you have a hearing aid as the oil will cause damage to the device.
Consultation - no wax removal required £25
The process starts with a consultation during which the clinician will take a more detailed medical history to help ensure it is safe to proceed with a physical examination and wax removal.
You will then be asked to sign a document providing consent for the clinician to proceed.
The clinician will then examine your ears with an otoscope. That examination serves a dual purpose. Firstly it will identify if wax is present, its condition and location and therefore if a wax removal procedure is indicated. Secondly it will assist the clinician to recognise anything that could make wax removal unsafe and therefore contraindicated such as a perforated eardrum or infection.
All being well your clinician will then recommend a treatment plan that may involve microsuction, irrigation or a combination of both. If however, it is decided wax removal would be unsafe your clinician will provide advice on self referral to your GP or A&E.
The consultation is provided at a cost of £25. The fee covers the clinician's time, expertise, and the use of any necessary equipment during the examination. If, it's determined ear wax removal is needed, the £25 consultation fee is deducted from the overall cost of the treatment meaning you will only be charged for ear wax removal if it is necessary.
Our aim will be to complete treatment during the same appointment. If the required ear wax removal cannot be achieved in one appointment we will arrange a second appointment to complete the process free of charge.
Wax Removal - including consultation fee £65
Microsuction
Microsuction is considered the ‘gold standard’ procedure when it comes to ear wax removal and the safest and cleanest way to remove earwax from the outer portion of the ear. This procedure involves the use of a high magnification head set to look inside the ear and a small hand held suction probe attached to a vacuum pump to gently but precisely target excess earwax from a moderately blocked ear canal.
The miscrosuction procedure actually starts when the clinician examines the ear with an otoscope. We have a saying that the wax decides what technique is used. That's the case as microsuction is used when a wax blockage is discovered in the outer half of the ear canal only.
During the procedure you must be seated and able to remain relatively still so as to ensure the clinician can both see the ear canal clearly and remove the wax safely.
Having examined the ear the clinician will gently insert a small cone shaped metal specula to a point just in front of the wax blockage. The specula is used to protect the delicate ear canal from injury and to guide the suction probe. The suction probe is then inserted through the specula and on to the wax blockage. The probe acts like a tiny vacuum cleaner gripping the wax allowing it to be removed safely resulting in many cases in an immediate improvement in hearing and ear comfort.
If however, following the completion of the procedure wax remains in the inner half of the canal the clinician will consider the use of warm water irrigation to complete the removal process.
Although microsuction is considered the safest and cleanest option it can be an uncomfortable experience for some, it can cause temporary dizziness in some and worsen existing tinnitus in others. Due to the fact ear wax adheres to the skin and hairs inside the ear canal removal by suction can irritate and in some rare cases cause bleeding, similarly there is always a slight risk of infection. That being the case the use of olive oil to soften earwax for three days prior to treatment is crucial whenever possible.
On the completion of treatment the clinician will re-examine your ears and provide the appropriate aftercare advice. If your ear canals appear irritated after the removal of stubbourn wax you will be advised to wear earplugs that the clinician will supply in order to keep your ears completely dry for four days after treatment and not to put your head under water for a further three days.
Microsuction is not suitable for all patients. In such cases, alternative methods may be recommended and in some rare cases treatment may not be possible. In such cases advice will be provided in relation to onward referral to your GP, an ENT Specialist.
Irrigation
Warm water irrigation is another method of ear wax removal recommended by the National Institute for Health and Care Excellence (NICE).
This process involves flushing the ear canal with gentle pulses of warm water that gets behind the wax and flushes it from the ear. Irrigation is not the same process as ear syringing which was previously carried out at GP surgeries. Ear syringing involved the use of large manually controlled syringes that had no means of water pressure measurement or control. That meant they had a potential to damage the ear drum if the pressure was applied too strongly. Syringing is now considered dangerous and should not be practiced.
In contrast warm water irrigation by means of a specially designed irrigation pump is much safer for our ears. That is the case as the flow and pressure of water is mechanically controlled, which allows only a safe amount of water at a safe pressure to be released at any time.
As before the process begins with the clinician conducting an examination of your ears with an otoscope. Warm water irrigation is the only choice for wax within the inner half of the ear canal and is favoured for larger quantities of stubborn wax.
During the procedure you must be seated and able to remain relatively still so as to ensure the clinician can both see the ear canal clearly and remove the wax safely.
The clinician will need access to warm water and a table or appropriate surface on which to place the irrigation machine. The water temperature will be close to body temperature. That will ensure maximum efficiency in terms of was removal, allow for comfort and reduce the risk of dizziness during the treatment.
During the procedure you will be required to hold a plastic cup to catch the water and wax from the ear canal. The tip of the water irrigator will be placed at the entrance to your ear and the clinician will control the water using a foot pedal. Steady but gentle pulses of water will rotate along the ear canal, work it's way behind the earwax flushing it from the ear canal. Both the technique used by the clinician and the specially designed tip of the irrigator will ensure the water first reaches the ear canal wall rather than the ear drum. This reduces the risk of damage to the ear.
Although warm water irrigation is considerably safer than syringing and avoids the risk or trauma created by the need for instruments within the ear canal as with microsuction it can be an uncomfortable experience for some. Prolonged irrigation to remove stubourn wax can result in reddening, irritation or pain, itchiness in the ear canal and in some rare cases bleeding. Similarly there is always a slight risk of infection particularly if there is an unknown ear drum perforation behind a wax blockage. It can cause temporary dizziness and vertigo that can lead to nausea in some and sometimes worsen existing tinnitus. That being the case the use of olive oil to soften earwax for three days prior to treatment is crucial whenever possible and bearing mind the listed contraindications.
On the completion of treatment the clinician will re-examine your ears and provide the appropriate aftercare advice. Having received irrigation you will be advised to wear supplied earplugs in order to keep your ears completely dry for four days after treatment and not to put your head under water for seven days.
Warm water irrigation is not however, suitable for all patients. In such cases, alternative methods may be recommended and in some rare cases treatment may not be possible. In such cases advice will be provided in relation to onward referral to your GP, an ENT Specialist.
Manual tools
Manual removal is the ‘traditional’ ear wax removal method where wax is removed using clinical tools such as curettes or Jobson Horne and forceps.
These tools are really useful to help with ear wax removal particularly when wax is near to the entrance of your ear canal and are used alongside microsuction and water irrigation as and when they are needed.