Otoendoscopic Earwax removal - String & Sheet of Earwax cleaning


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Published on 11/01/2015

This Video show Otoendoscopic Earwax removal by microsuction - String & Sheet of Earwax cleaning .

Patient presented with ear blockage , tinnitus & decrease hearing .

No wax dissolving ear drops , local anesthesia & sedation use during procedure .

Patient is very comfortable during whole procedure .

Ear Wax :
Earwax is a waxy material produced by sebaceous glands inside the ear. It cleans, lubricates and protects the lining of the ear by trapping dirt and repelling water.
Earwax is slightly acidic and has antibacterial properties. Without earwax, the skin inside your ear would become dry, cracked, infected or waterlogged and sore.
Earwax can be wet or dry, hard or soft. Soft earwax is more common in children and hard earwax is more likely to cause problems.
Everyone makes ear wax but the amount and type are genetically determined just like hair color or height.
Some people have ear canals that are smaller than average or shaped in a way that makes it difficult for the naturally occurring wax to get out of the canal causing wax impactions.
Some people produce more earwax than others. It usually falls out of your ear gradually, in small pieces or flakes. Sometimes, earwax can build up and harden, creating a blockage called a "plug".
As well as causing discomfort, an earwax plug can also cause temporary hearing loss because it blocks your ear canal. Once the blockage is removed, your hearing will improve.


Some people are naturally more susceptible to developing a blockage in their ear, for various reasons.

Blockage, or impaction, also occurs when the wax gets pushed deep within the ear canal. Earwax blockage affects about 6% of people and is one of the most common ear problems doctors see.
Your risk of developing problems from a build-up of earwax is increased if you have:
• narrow ear canals or ear canals that aren't fully formed
• a lot of hair in your ear canals
• bony growths in the outer part of your ear canal – these are called osetomata
• a skin condition of your scalp or preauricular area
• hard wax
• a history of recurrent impacted earwax
• repeated ear infections
Elderly people are more at risk of having earwax problems because earwax becomes drier with age.
Impacted earwax
If you produce a lot of earwax, further blockages may occur, even after you've had an earwax plug removed.
Further blockages are also likely to occur if you have particularly narrow ear canals that become blocked more easily.
Your chances of developing an earwax blockage are also increased if you:
• use cotton buds – they can push earwax deeper into your ear and pack it together harder, creating an earwax plug
• wear a hearing aid or earplugs, which can stop earwax falling out of your ear naturally

Symptoms of earwax build-up
Earwax doesn't usually cause problems, but a build-up of earwax can lead to a
blocked ear or fullness sensation,
ear pain and
hearing loss.
Too much earwax can also cause other symptoms, including:
• Ringing in the ear
• Itching or drainage from the ear canal
• vertigo or Dizziness

Treating earwax build-up
In most cases, earwax falls out on its own, so there's no need to remove it. However, if it's completely blocking your ear canal and causing hearing loss, it may need to be removed.

Indications for earwax removal :

• Difficulty in examining the full tympanic membrane
• Otitis externa
• Wax occlusion of the external ear canal
• As part of the workup for conductive hearing loss
• Prior to taking the impression for hearing aid fitting
• Suspected external ear canal or middle ear cholesteatoma
• As part of the follow-up to canal wall down mastoidectomy
• As part of grommet insertion or middle ear surgery
• Patient request

Methods of Earwax Removal :
Eardrops can be used to soften and loosen the earwax.
Eardrops should not be used if you have a perforated eardrum .
Ear irrigation-
Ear irrigation may be recommended if your earwax blockage persists, even after using eardrops. It involves using a pressurised flow of water to remove the build-up of earwax.

Microsuction –

where a special suction device is used to remove the earwax under a microscope. The procedure is quick, safe and painless.

Aural toilet –

where an instrument called a Jobson Horne probe is used. A Jobson Horne probe is a thin metal instrument with a small ring at one end that the specialist can use to remove earwax from your ear canal.

Complications of Earwax Blockages

• Perforated eardrum
• Middle-ear infection
• External-ear infection (swimmer's ear )

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