Practice Guidance: Aural Care (Ear Wax Removal)
British Society of Audiology. (2021).
Bathgate (United Kingdom): British Society of Audiology, 1-34.
This guideline from the British Society of Audiology (BSA) provides recommendations regarding the removal of cerumen (i.e., ear wax) that is causing reduced hearing or other symptoms in adults. The current BSA guidance provides detailed, step-by-step directions for removing ear wax and contraindications for each removal method. The following summary highlights broad recommendations to consider. See the BSA's full text document for all of the recommended steps for ear wax removal in routine ears.
British Society of Audiology (United Kingdom)
During ear wax removal procedures, the ear canal should ideally be viewed under magnification with a light source (e.g., binocular microscope, endoscope). Otoscopy or video otoscopy can be used throughout the procedure.
Equipment used for ear wax removal should be kept clean and adhere to infection control policies, be appropriate equipment designed for ear wax removal, meet minimum safety and quality standards, be maintained on a planned preventative maintenance schedule, and be used appropriately during ear wax removal procedures to minimize potential risks.<br /><br />Aural care and ear wax removal should be conducted in a well lit environment conducive to effective infection control with appropriate waste management facilities available.
Methods for ear wax removal that are not considered safe and are <span style="text-decoration: underline;"><strong>not</strong></span> recommended include manual syringing, self-irrigation, and use of Hopi candles.
After undergoing ear wax removal procedures, patients should be given information on possible post-aural care symptoms and when to follow-up with their provider. Patients should also receive education regarding prevention and reduction of ear wax levels, use of appropriate over-the-counter treatments, and the importance of regular check-ups.
Audiologists and healthcare professionals must be trained and supervised in any wax removal procedure(s) until they meet the training requirements of any regulating body and/or employing organization. Practitioners should also adhere to infection prevention and control procedures. Patients with contraindications to a particular ear wax removal procedure should be referred to a clinician with expertise in a method for ear wax removal appropriate for the patient's condition.
Appropriate methods for ear wax removal in adults include:
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<ul>
<li>simple extraction instruments (e.g., loops, curettes, forceps),</li>
<li>electronic water irrigation machines, and</li>
<li>suction devices.</li>
</ul>
<div>See the BSA full text for detailed description for each procedure, possible risks and complications, and contraindications.</div>
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Immediately following ear wax removal procedures, patients who indicate that their hearing has not returned to baseline should be offered a hearing test with tympanometry.
