Ear wax removal: A survey of current practice

Abstract

Objective - To determine the methods of removing ear wax used by local general practitioners and the incidence of associated complications. Design - Postal survey of 312 general practitioners serving a population of about 650 000; supplementary study of ear, nose, and throat outpatients to quantify the improvement in aural acuity after wax removal. Setting - Catchment area of the Edinburgh otolaryngological unit. Participants - 289 General practitioners who responded to the survey; 21 outpatients in the ear, nose, and throat department with occlusive wax. Results - 274 General practitioners removed wax by syringing, but only 53 (19%) always performed the procedure themselves; the remainder routinely delegated the task to practice nurses, some of whom had received no instruction. Ears were rarely examined again after the procedure. Complications had been experienced by 105 practitioners (38%) and included perforation, canal lacerations, and failure of wax removal. The removal of occlusive wax improved hearing by a mean of 5 dB over the frequencies analysed. Conclusions - About 44000 ears are syringed each year in the area and complications requiring specialist referral are estimated to occur in 1/1000 ears syringed. The incidence of complications could be reduced by a greater awareness of the potential hazards, increased instruction of personnel, and more careful selection of patients.