Ear wax, candling and syringing

Ear wax is a common affliction. Whilst the conventional wisdom is that the ear canal is self cleaning, my own experience is that some people have persistent problems with wax and require medical attention.

The pictures below are of a healthy ear canal with minimal wax and another with a large wax plug. This plug was eventually removed.

Normal ear canal. Wax is produced by the hair-bearing skin

Wax plug occluding a ear canal

Wax plug removed

There are a variety of solvents available for earwax but most of them contain irritants which may lead to further problems. Indeed I often see patients who have had solvents prescribed by their primary physicians and have then developed an ear canal infection (otitis externa).

Syringing of the ear canal is a widely accepted strategy for removing wax. Unfortunately this method is sometimes ineffective and can lead to problems when there is a perforation of the ear drum.

Ear candling has been growing in popularity. The pictures below were taken at my local shopping mall in Singapore!

Ear candling is not to be recommended. The USFDA has a strong advisory against it. I quote “there is no evidence these devices work as directed. But they do carry risks of serious injury, including burns to the face, ear, and ear canal, and clogging of the ear canal with hot melted wax from the ear candle itself”

The safest and most effective way of removing wax remains microsuction. This involves suction clearance of wax using a surgical microscope. Wax can be removed precisely and any infection or damage to the ear canal or eardrum be addressed at the same time.

A speculum (like the ones picture below) is inserted into the ear canal.

And fine suction tips are used to clear the wax gently and accurately from the ear canal

This is the common set up for ear microsuction. It is comfortable and most children over 6 years can tolerate this procedure.

Share this blog via: