Ears and Wax

I know there have been one or two previous threads on this but I wanted to add my experience and thoughts on what is a critically important subject, following recent events and in the hope I might save other people from a fate that befell me.

Nothing you do with your system/room is worth much if you’re ears aren’t in best condition - I’m only talking wax, here. The thing about wax build-up is it tends to be slow and we often don’t notice how much our hearing drops off as a result. I spent months trying to work out why one channel sounded less detailed in the higher frequencies than the other. I’ve had a history of wax that needs removing every 3/4 years so I should have known better, but the thumb-and-finger test (I rub finger and thumb together next to each ear to hear if one is duller than other) revealed such a small difference that I thought it had to be gear-related. Eventually, the highs dropped off so badly I knew it had to be wax and nipped in to see the nurse at my surgery. She confirmed one clear ear and one blocked.

Now here’s some advice. I seriously recommend avoiding irrigation (by electronic pump) or manual syringing. (Though I’d be surprised if anyone still practises syringing). I’d had irrigation three or four times in the past by very careful nurses, with no ill effects. Last one, however, went at my ears with too much aggression and I ended up with awful pain, vertigo and tinnitus a day later. Four years later the tinnitus is permanent, though it varies in intensity, vertigo is awful if I have a cold and I get earache if I crank the volume. Instead, get micro suction - which I had for first time, yesterday. Unlike irrigation, it’s an exact science - consultant can see what he’s doing by camera - and so should be entirely safe. It took about 3 minutes. It’s now clear there’s nothing wrong with my left channel at all and a lesson to me just how much the sound is affected by even what one otherwise perceives as only a small amount of hearing degradation. I’m now listening to what sounds like an entirely different system.

So, if you have any inkling you might be suffering from excess wax, I recommend get it looked at. Even if you don’t, it’s worth asking the doc to take a quick look next time you’re in the surgery. In a nutshell:

Ask your doc’/practise nurse to check your ears - in UK it’s free and takes about 60 seconds.
If there’s wax that needs removing, get it micro-sucked out, after 10 days of ear drops. (Weeks of using ear drops to remove it is painfully slow, increasingly uncomfortable and not guaranteed to work). If your GP practise doesn’t do it, find someone who does.
Then enjoy everything your system is delivering.

In a previous thread I read about people buying cameras and attempting clearances themselves, sometimes, apparently, in the name of saving the cost of (private) treatment. IMO this utter folly. The ear is an incredibly delicate, finely tuned instrument, very easily damaged. Once damaged, it’s unlikely to ever return to normal. As one poster said, the only thing you should ever get near it is your elbow. Think of it, instead, like this: How many hundreds and thousands do you spend on your gear? In the scheme of that, what is £130? (That’s what my suction cost).

Hope this is of use to y’all.

p.s. Mr Halibut - I was sorry to read about your experience. Anything which interferes with our greatest passion is a matter of some considerable upset. All we can do is adapt and make the absolute best of it.

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FWIW, I use Otex if I get a wax build-up my ears.It may not work on compacted wax, but is subtly effective. It is surprising how much wax can build up.

After a flight to Montreal I ended up very hard of hearing. Rummaging around in my ears walking around in Montreal fortunately produced copious amounts of wax that I assume had shifted from deeper in my ears to nearer the surface, as it were.

I have had my ears syringed a couple of times, but actually found the after-effects much less pleasant than the procedure itself.

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I used Otex on the compacted stuff, Al and it worked well to soften it for sucking out. I might try a few drops once every couple of weeks to try to reduce the compacting going forward.

You might try micro suction if there’s a next time - zero after-effects.

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In UK GPs are not supposed to offer syringing any more because it’s so risky and generally you have to get micro suction privately if you want it anytime soon.

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Spot on!

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My practise still does irrigation. It should be banned IMO. Yes, private for micro’ is most likely but, small price to pay, in context…

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Sorry but that is wrong. Syringing is safe and effective if done using an electronic irrigator which is in use in most surgeries and available free. Manual syringing is not recommended.

From NICE Guidelines: Scenario: Management | Management | Earwax | CKS | NICE

How should earwax be removed?

If earwax removal is indicated:

  • Advise the use of ear drops to soften wax and aid removal. Options include sodium bicarbonate 5% ear drops, olive or almond oil drops, and sodium chloride 0.9% nasal drops (off-label use as ear drops).
    • Advise the person to use the drops 3–4 times daily for 3–5 days initially.
    • Warn the person that instilling ear drops may cause transient hearing loss, discomfort, dizziness, and irritation of the skin.
    • Advise that removal of earwax may not necessarily relieve the symptoms (for example hearing loss may be a sensorineural loss and not due to impacted wax).
    • Do not:
      • Recommend ear drops if you suspect the person has a perforated tympanic membrane, active dermatitis, or active infection of the ear canal.
      • Recommend almond oil drops to people who are allergic to almonds.
  • If symptoms persist:
    • Consider ear irrigation (flushing the wax out using water) using an electronic irrigator provided the expertise is available, there are no contraindications to the method, and the person is advised on the possible risks and adverse effects of the procedure.
      • When carrying out ear irrigation, use pre-treatment wax softeners, either immediately before ear irrigation or for up to 5 days beforehand. The Rotherham NHS Foundation Trust has a guideline on Ear irrigation.
      • Following irrigation, examine the ear with an auriscope to check that the wax has been removed and that the tympanic membrane is intact. Look for old, healed perforations. Inspect the canal for otitis externa.
      • Seek immediate advice from an ear, nose, and throat specialist if severe pain, deafness, or vertigo occurs during or after irrigation, or if a perforation is seen following the procedure.
      • If irrigation is unsuccessful, repeat use of wax softeners, or instil water into the ear canal 15 minutes before repeating ear irrigation.
      • If irrigation is unsuccessful after the second attempt, refer the person to a specialist ear care service or an ear, nose, and throat service for removal of earwax.
    • Microsuction (using a vacuum to suck the wax out under a microscope) or another method of earwax removal (such as manual removal using a probe) may also be considered if the expertise is available and there are no contraindications to the methods.
    • Do not offer adults manual syringing to remove earwax.

Nevertheless I think you’ll find that most surgeries have stopped syringing…

I have a bit of a bee in my bonnet about this as my own inclination is that we should continue to offer syringing but I’m very much in the minority…

I do not have a problem with ear wax. My problem is tinnitus. Especially when you listen to music.
As far as i know there is no cure. Some musicians who have it can no longer perform.
If one loves music this is the worst thing to happen.

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I’ve had ear wax for years and years sleep on the side and I think it blocks them up. Had syringing in the past but yes now all the GP says is to use Olive Oil for about 2-3 weeks. Easier said than done when you’re deaf in one ear everything is really hard like driving. Listening to hi fi near on impossible sounds awful. These days Otex does the job but last time GP prescribed something a bit stronger and that cleared it. It sounds so utterly weird when the ear clears everything is “hissy” for a few hours whilst getting back to normal. Why some people have it and others don’t is an odd one

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Sorry to hear your experience. I get an annual medical and have my ears checked for any wax as had build up when I was a child. Thankfully syringe did not cause any issues then but GP only does suction now after 5 days of drops.

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I did have suction many years ago. Had to go to local hospital. Not sure I like them hoovering inside the sensitive areas

I think many modern GPs have moved on, but no doubt some older ones cling on to what they know.

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RK - syringing (by which I actually meant electronic irrigation but which, for sure, includes the old manual plungers) is not ‘safe’ at all IME. It’s a lottery. It relies on a practitioner guessing where to direct a jet stream of water at a guessed-at pressure (which they set and then ‘suck-it-and-see’) for a guessed-at period of time. In the worst case it can result in a perforated ear drum. Why expose yourself to the risk when you can have suction under exacting camera guidance? I did find the suction very noisy at moments but infinitely better than the pummelling and subsequent problems my ear drums suffered from the irrigation. Previous operator ineptitude likely didn’t help.

Note: I’ve now edited my posts to account for the difference between ‘syringing’ and ‘irrigation’.

Much better than the alternative, Ian…

I sympathise, Brian…

If you need wax removal, try suction, Svetty - you’ll never go back.

What are the possible side effects of Microsuction?

The clinical practitioner will discuss the possible side effects and risks prior to treatment.

As with any procedure, Microsuction carries a small amount of risk and potential side effects, most of which are very rare. The most common side effect is some dizziness, faintness or vertigo during or shortly after the procedure. This is temporary and is because Microsuction ‘cools’ the temperature of the ear canal.

There is a small risk of infection.

As a tube is being entered into the ear canal, there is a small risk of damage or trauma occurring to the canal and eardrum. In very serious cases, this can include perforation of the eardrum, but this is rare.

During Microsuction, there is some noise generated by the equipment. Some people find this noise to be very loud. In some cases, this can lead to hearing loss, which may be temporary or permanent. It may also cause tinnitus or worsen existing tinnitus. It is worth noting that this is also a rare occurrence.

Removing wax is one of the few things in general practice that gives an instant cure. As with any intervention there are possible side effects. Rare both for irrigation and microsuction but does happen with both. Leave the wax if you wish. Valid choice.

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Retiring 22 April :slightly_smiling_face: