Endoscopic Ear Wax Removal

ENDOSCOPIC EAR WAX REMOVAL & E-SUCTION®

WHAT IS IT?

Endoscopic ear wax removal is when ear wax is removed from the ear with the help of an endoscope. The endoscope is used to directly visualise the ear wax whilst it is being removed using either ENT micro-instruments (e.g. ear hook, jobson horne) or gentle suction with a low pressure suction machine and fine sterile probe. This is known as ‘endoscopic ear suction’ or  ‘E-suction®’.


HOW IS IT PERFORMED?

The procedure is performed by Audiologists, Hearing Aid Dispensers and ENT doctors using an ‘ear’ endoscope (oto-endoscope). An endoscope is an instrument used to look inside the body and is usually attached to a video monitor for easy viewing, although direct viewing is also possible through the eyepiece of the endoscope. At CLEARWAX we have specially designed and developed our own video oto-endoscope for ear wax removal called the ‘iCLEARscope®’. The tip of this light-weight, portable and easy to operate video oto-endoscope is placed into the ear canal opening to provide a high-definition (HD) and wide ‘panoramic’ view of the entire ear canal and ear drum to facilitate effective ear wax removal.

Endoscopic ear wax removal typically takes between 10 to 25 minutes to perform. This can vary depending on the amount and type of of ear wax, how deep the ear wax is inside the ear canal, if ENT instruments or E-suction® is being used and whether you are having one or both ears treated. It is usually performed with you comfortably sat on a chair with your head titled to the side slightly so that the ear with ear wax can be easily accessed.

To watch how endoscopic ear wax removal is performed please click here.


THE BENEFITS 

Unlike ear syringing or ear irrigation, where ear wax is flushed out ‘blindly’, with endoscopic ear wax removal the ear wax is being directly viewed with the endoscope whilst it is being removed. This makes the procedure much quicker, safer and comfortable for the patient. Other benefits of endoscopic ear wax removal and E-suction® include:

  • A much wider view of the ear canal and eardrum compared to a microscope.
  • There is not always the need to apply ear drops for wax (e.g. olive oil or sodium bicarbonate ear drops) for several days or weeks beforehand, which is the case with ear syringing or ear irrigation. Nonetheless, the use of ear drops is still recommended where ever possible for one or two days prior to having endoscopic ear wax removal performed.
  • No water is being flushed into the ear canal like for ear syringing or ear irrigation. Instead the procedure is performed ‘dry’ significantly reducing the risk of infection and accidentally ‘pumping’ ear wax deeper into the ear canal.
  • Unlike ear syringing and ear irrigation, it can be performed in people who have a perforated eardrum or grommet, mastoid cavity and cleft palate, in addition to any foreign object (e.g. children’s marble) that may be lodged inside the ear canal.


LIMITATIONS AND SIDE EFFECTS 

Endoscopic ear wax removal is regarded as being safe and well tolerated. In fact, it was clinically found to be quicker, easier and more comfortable than microscopic ear wax removal in a clinical study¹ comparing the two approaches. However no treatment of ear wax is completely ‘risk-free’. Some of the risks and side effects of ear wax removal shared with endoscopic ear wax removal include:

  • Damage and trauma to the ear canal and eardrum (including perforation).
  • If E-suction® is being performed a loud noise can be generated in the ear canal due to the suction. In some people this can cause hearing loss (temporary or permanent) and tinnitus (ringing type noise inside the ear) or worsening of it if already experienced. This is rare.
  • E-suction® ‘cools’ the temperature inside the ear canal which can lead to faintness, dizziness or vertigo. This is due to the ‘caloric’ effect and is normally short lasting.

 

1 Pothier D.D., Hall C. & Gillett S. (2006) A comparison of endoscopic and microscopic removal of wax: a randomised clinical trial. Clin. Otolaryngol. 31, 375–380

Video: Endoscopic ear wax removal by E-suction® with the use of iCLEARscope®

Video: Endoscopic removal of a foreign body in the ear using the iCLEARscope® and ENT crocodile forceps

E-suction earwax removal

Image: Mr Rejali (Director and Consultant ENT Surgeon) performing E-suction® using the iCLEARscope®