Ear Wax Removal Patient Information – Hearbase

Hearbase Ear Wax Removal Patient Information

This information is intended as a guide for patients when using the Hearbase Ear Wax Removal Service so that you are aware of the preparation, procedures and post-procedure care that is necessary for each visit to our service.  

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Hearbase ear wax removal clinics 

We run private clinics across Kent on our own premises or in Health Centres. Your appointment will be with an Audiologist or Health Care Assistant who has completed training in the removal of ear wax, meeting the criteria set by the British Society of Audiology. Each of these Ear Care Practitioners reports to our Clinical Manager and will adhere to the British Society of Audiology Practice Guidance Aural Care (Ear Wax Removal) 2021, relevant NICE Quality Standards and local policies. 

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Excessive ear wax and why it needs to be removed. 

Excessive build-up of wax can cause hearing difficulties and discomfort. It may also contribute to ear infections. Patients using hearing aids may find that they are unable to use these effectively. Ears need to be clear of wax for diagnostic hearing tests and impressions. Occasionally the wax is hiding an undiagnosed pathology and your ear care practitioner will alert you to any findings. The wax may also be accompanied by a build-up of dry skin (keratin), and this can also cause pain and infection.  

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Suitability for our wax removal service 

When you contact Hearbase, you will be asked some health screening questions by our team. They will advise you if an appointment in our wax clinic is suitable. 

This triaging stage is necessary as there are contraindications to some procedures, including recent ear surgery, perforated ear drums, having mastoid cavities, grommets, or infection. We may suggest that you should see your GP or a medical professional in an Ear Nose and Throat Clinic. 

Some ear care practitioners offer suction clearance only, and if that is something that you do not wish to have, please advise our administration staff, so they can book an appointment in a clinic where other methods of wax removal are available.  

Please be aware that our ear care practitioners may unfortunately still have to decline wax clearance, at the appointment, if they discover any contraindications, and they will stop procedures if there is active infection, pain, or underlying pathology present.  

We may be unable to remove the wax due to its consistency or depth of impaction, particularly if it is on or near the ear drum, and some patients may still require a GP referral to an ENT specialist.  

We may need to offer a second visit, which will be free of charge, to remove the wax safely. If after the second visit we are unable to clear the wax we will write to your GP and suggest that they see you or refer you to ENT. 

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Preparation for your appointment 

If you believe you have excessive ear wax and have answered all our health screening questions correctly then our triage team will be able to advise you if you should or should not soften the wax before your appointment.  

If we do advise wax softening, we suggest that you use Earol® Spray, an olive oil preparation, according to the manufacturers’ guidelines, at least 2 times daily, for 5 days preceding the appointment. 

As the wax softens, your ear may feel fuller as the wax expands, and you may experience mild irritation, or fluctuation in your hearing. If you have pain or signs of infection, you must seek advice from your GP and contact us to advise us that you have stopped the softening and we will cancel your appointment, if necessary, depending on the outcome of your GP consultation. 

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Risks and complications associated with ear wax removal 

All medical procedures have an element of risk involved and we need to gain your formal informed consent before we begin to examine your ears. 

The signed consent form will be kept on your records, so we need to obtain consent to hold your personal data according to UK General Data Protection Regulations. 

Over-cleaning of the ear canal can disrupt the skin causing the natural microbes of the skin surface to enter the lower epidermal layers of skin resulting in an outer ear infection (otitis externa) so only “necessary” ear wax removal will be performed. 

The risks of wax removal are dependent on the method of removal, but each practitioner adheres to best practice to minimize the following risks: 

Physical trauma -of the to the skin of the ear canal walls and ear drums – bruising, abrasion, bleeding, perforations. Risk of bleeding is increased in patients who take blood thinners or have certain underlying health conditions. 

Pressure trauma -to the ear drums due to pressure from the water, irrigation, or suction device. Physical trauma is also possible if you move suddenly during the procedure, so we request that you maintain stillness through the procedure and always say “stop” if anything is uncomfortable. 

Infection developing after the procedure – increased when the skin of the ear canal is already disrupted before the procedure with pre-existing conditions such as eczema 

Vertigo -some patients may experience transient dizziness due to temperature and pressure changes. In exceedingly rare cases patients may vomit or faint. The risks are increased if you have pre-existing vertigo or high or low blood pressure. 

Tinnitus and hearing loss –noise levels from some wax removal equipment can exacerbate pre-existing tinnitus and in rare cases trigger newly presenting tinnitus. The noise levels may also cause a temporary reduction in hearing. Physical trauma can also cause hearing loss. 

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Wax removal procedures 

The ear care practitioner may use an otoscope, Tympa System, video-otoscope, endoscope, binocular microscope, or Loupes, to examine your ears. Different methods may be used even in one session. 

The ear care practitioner will tell you what they see, in each ear. If there is minimal or no wax, there will be no further procedure.  

If the practitioner discovers any contraindication there will be no further procedure. 

If excessive wax is found the practitioner will discuss the most appropriate method of removal so that you are fully involved and aware of the procedure. Sometimes a combination of methods will be used. 

Manual extraction – fine tools such as forceps are used to gently clear the wax.  

Water irrigation – an electronic water irrigator using controlled water pressure gently circulates water in the ear canal. The ear canal is then dried with a cotton wool wrapped curette. We protect your clothes as far as possible from getting wet, but we are unable to guarantee this. 

Suction – an electronic suction device modified for use for aural suction is used to suck the wax from the ear canal, via a slim metal tube. 

On occasions we may administer Earol® olive oil spray to help to soften the wax. If the wax is extremely hard or too deep in the ear canal, we will stop the procedure and discuss your care plan. 

The ear care practitioner will give a detailed explanation of the procedure and you will need to follow all instructions such as keeping your head still and using a verbal prompt if there is any discomfort. 

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Outcomes and after care advice 

Where the practitioner feels they have a significant clinical finding they will discuss this with you and seek permission to contact your GP via letter. 

If there is any trauma to the ear or side effect the practitioner will explain how to manage this immediately after the procedure. 

In some exceedingly rare instances, the findings may warrant need to seek immediate advice from a GP or an Urgent Referral Centre, or A&E Department, particularly if we note serious infections or previously undiagnosed perforations. 

We may offer audiological tests if we need further evidence to support our findings and we will discuss this with you on the day.  

Once you leave the appointment you must contact your GP as soon as possible if discomfort, pain, swelling, discharge, or odour occurs, or if there is any disruption to your hearing, balance, or tinnitus is experienced. The GP will need to examine and manage the issue or make any necessary referrals. Please also contact Hearbase to report this, so that we can add this event to your records.  

The number to call is 0800 028 6179 or email admin@hearbase.com

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General self-care of your ears 

Wax build-up may recur, and you may need regular ear care. If, after the appointment, your ear care practitioner has found that your ear canals and ear drums are entirely normal, it may be recommended that you use Earol® olive oil spray regularly. This helps to moisturize the ear canal, reduce hardening and impaction of wax, and helps reduce mild irritation. 

However, if your ears are not healthy you will need to be seen by your GP regularly for an ear check to ascertain if the wax needs to be removed by an ENT doctor, ENT Specialist Nurse Practitioner of GP with Special Interest in ENT. 

In all cases please do not use any cotton buds or other devices to manually remove the wax, and do not use home irrigation kits or Hopi Ear Candles. 

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Service Charges 

A fixed charge is payable in advance or on the day of the appointment. We charge for the appointment whatever the outcome. If we need to see you once more to remove residual wax, after further softening, that will be free of charge. 

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Complaints or compliments 

Your feedback is welcome to assist monitoring our service provision so please email or call our head office in Folkestone with any comments or suggestions. 

Call 0800 028 6179 or email admin@hearbase.com

140 Sandgate Road Folkestone CT20 2TE 

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References –  British Society of Audiology Practice Guidance Aural Care (Ear Wax Removal) 2021, nice.org.uk 

Date of next review for this website information page: October 2022