What is microsuction?

Learn more about ear wax removal using microsuction.

Audiologist performing microsuction

What is microsuction ear wax removal?

You might have been looking at getting ear wax removed out of your ears, and heard the term ‘microsuction’ being mentioned. What does this mean? How does it differ to other ear wax removal procedures available? What are the risks? Read on to find out more about the use of microsuction for ear wax removal.

Ear wax is your bodies way of removing dead skin cells from your ear. Two glands in your ear (the ceruminous and the sebaceous glands) together produce an oily substance (cerumen) which naturally migrates out of the ear canal.

This normally works perfectly fine, however occasionally things don’t go as they should, and a wax build up can occur. This happens for a variety of reasons, some of which can be age related, such as the glands reducing in size and not working as effectively. Other reasons include foreign objects blocking the ear, or ear wax that has been pushed deeper inside the ear due to use of items like cotton buds.

A small build-up of wax is not normally an issue and, in fact, it has anti-inflammatory properties and can protect the very sensitive ear canal. However, when ear wax builds up excessively, and blocks up the whole ear canal, this is known as impacted wax.

Whatever the reason for a wax blockage, it can often leave an individual with a feeling of fullness, temporary hearing loss, or tinnitus, and sometimes can even be painful. In these cases, where the problem doesn’t resolve by itself, it is often best to seek professional advice to get it removed.

What can I do to get rid of excessive ear wax?

It’s probably a good place to inform you what not to do here, and that is to try and remove ear wax yourself with a cotton bud or other object you might find that fits down your ear canal. You are likely to push any wax further down your ear, closer to your ear drum, and, whilst you might see a bit of wax come out, most is probably still inside. There is also a huge risk here of damaging the sensitive skin in the ear canal and causing abrasions which could lead to infection.

Another method to avoid is the use of ear candles, also known as hopi ear candles. Whilst they might sound like a clever idea, using heat to create a vacuum which sucks any wax out of the ear, unfortunately there is zero evidence they make any difference at all to ear wax. Try burning one without putting it in your ear and you are still going to see a residue which many people think is ear wax inside.

What does help remove ear wax? Seeing a professional who is able to safely and effectively remove it from your ear of course!

Whilst previously this may have involved visiting your local GP surgery, unfortunately, many NHS providers across the UK no longer provide this service, and so we have to look for local professionals able to take the wax out safely.

Most private audiology clinics will offer a wax removal service or be able to recommend someone locally. There are also some pharmacies who offer it, as well as nurses. Services may be offered in a clinic, or sometimes as home visits.

What kind of wax removal is available?

Whilst there are many options for getting your excessive ear wax removed, it is often conducted by different types of professionals, using various different methods.

You may have heard of ear syringing or ear irrigation. This is where a low pressure jet of water is pumped into the ear and a basin is placed under the ear to catch the water and associated wax that has been removed. In effect it is flushing out of the ear canal.

Irrigation has risks associated with it, as flushing water into the ear can affect your balance organs which are located in your inner ear. Some machines are temperature controlled which reduces this risk, however it may still cause dizziness or vertigo. There is also a risk of ear infections, pain, and tinnitus. Irrigation cannot be used if you have any perforations (holes) in your ear drum.

Wax can also be removed using manual instruments. This is when the ear wax removal professional uses specialist tools to remove the ear wax from the ear canal. These tools include a ‘Jobson horn’ which is like a very tiny open spoon that can be used to move wax out of the ear; a ‘St Barts Hook’ is an instrument which hooks into ear wax; and ‘crocodile forceps’ can be used to grab onto harder wax to pull it out.

These tools tend to be used for wax that is closer to the opening of the ear canal, and are generally used in conjunction with another wax removal method.

Then we have microsuction. An ear wax professional using microsuction will have equipment allowing them to look inside your ear. This could include loupes (magnification that sits in front of the eyes), microscopes, or a tool like the TympaHealth system which magnifies the inside of the ear canal and displays it on a screen.

This will then be combined with a microsuction system that is like a very gentle vacuum. Whilst looking inside your ear the professional will very carefully remove the ear wax – some may be sucked into the vacuum, and sometimes it latches on to the wax and we are able to move it out of the ear.

At Alto we favour this method (combined with manual instrumentation or ear irrigation, where necessary), as it is a safe, quick and effective way or removing wax from the ear canal. The system we use is designed by TympaHealth, and this allows us a great magnified view of what we are doing on the screen of an iPhone. We can also store images and videos, and if there is something unusual, we are able to have these images reviewed by ENT specialists very promptly which is extremely beneficial. There are times where the use of irrigation may be required, however this will only be performed where it is necessary and safe to do so.

There are a few risks associated with microsuction, although generally it is considered the safest way to remove wax from the ear.

Possible risks include:

  • It may not be possible to remove all wax during your first microsuctio procedure. Therefore, you may require a follow-up appointment.
  • Sometimes microsuction may cause slight abrasions or bleeding in the ear canal.
  • Microsuction may exasperate any tinnitus temporarily.

Do I need to do anything before having microsuction?

Yes, it is really helpful if you have softened up the wax by inserting olive oil into your ear for three days prior to your apointment. Olive oil will make the wax easier to remove, which means it will be more comfortable for you too. The easiest way to insert olive oil is to use a spray such as Earol, rather than dropping it in, as a spray will give better coverage.

What happens during an Alto microsuction appointment?

When you arrive you will be greeted by your audiologist or wax removal professional who will ask you some questions about the problems you are experiencing, and take some medical history to ensure it is safe to proceed.

Consent will be gained to go ahead with the procedure and you will be notified of any risks. The hearing care professional will then examine your outer ear and have a look inside your ear using an otoscope. They will also take some pictures.

If it is safe, they will then use the microsuction equipment to remove the wax from your ears, one ear at a time, and allowing time for breaks and to ensure you are comfortable. Dependent on how your ear wax presents, they may also use manual instruments or ear irrigation, where it is appropriate and safe to do so.

Once the wax has been removed, they will use the otoscope again and take some more pictures to show you the before and after photos.

You will then have some headphones placed on your ears and an AltoScreen hearing screen will be conducted to check your hearing.

Finally, any referrals will be made, or appointments for further investigation will be booked, as necessary.

Article by Adam Bostock

Customer Service

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1 Shambles Court,
Bell Street,
LE17 4DW

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