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Keeping Those Waxy Ears Clean: Ear Wax Management Blog - July 2022


There is a lot of misinformation out there when it comes to keeping your ears clean and lots of different ear cleaning kits on the market. So how do we know which is best? Since I am fairly new to the field of Cerumen management aka Ear wax removed, I consulted audiologist, Vanessa Rentschler, Au.D., CCC-A and asked her what she thought was best.


Dr. Rentschler has told me repeatedly, “It’s generally not recommended to use Q-tips,”

So I asked, “Why?”


“The ear canal is generally self-cleaning, meaning there is no need for the average person to go poking around in there. Cerumen has properties which are healthy for the ear (pH levels & bacteriostatic), and is designed to naturally slough off with dead skin cells and oil/sebum, migrating to the opening of the ear canal where one can absorb/wipe it away with a washcloth or tissue. The Q-tip does absorb some of this wax, which people see as evidence that they are being diligently hygienic. However, usually what the individual cannot see is that the wad of wax that was about to work its way out of the ear canal just got mashed further up in there. *That* is typically when we see people in the clinic for ‘impacted cerumen,’ which is likely more painful to remove from that more medial (deeper) bony portion of the ear canal.


There are also risks of course, like going in too far and puncturing the eardrum (on more than one occasion I have had patients who kept the Q-tip propped in the ear while they did other thing like brushing their teeth… and a family member spontaneously opens the bathroom door, hitting the other end of the Q-tip and traumatically shoving it through the eardrum!). Also, people who are immunocompromised or taking blood thinners are at increased risk of scraping the skin and excessively bleeding and/or introducing infection, as the skin lining the ear canal is particularly thin. Any radiation treatment for head and neck cancer also makes the ear the last place one should be penetrating with unsterilized tools or clinical know-how.


As a side note, also be wary of ear-candling, as that is not only an ineffective method in removing cerumen (the heat feels nice and you open it up to see the ‘earwax,’ but it is really just the candle wax), but this also poses a risk of burn injury, from the flame itself or dripping hot wax into your ear canal. Ultimately, for the average person with no significant otologic (medical ear) history, there is no need to even think about this. Professional/clinical removal may be required for things like fungal infection (goopy/itchy ears), complete impaction/occlusion, or anyone who has had surgery on their ears like a mastoid cavity or PE tubes.


My strongest take-home message would be, if someone is reporting that one of their ears feels plugged-up and/or their hearing suddenly feels muffled (on one side, cerumen impaction is not terribly likely to occur at the same moment on both ears), they could try some safer cerumen removers designed for consumers over-the-counter. If someone has any kind of the aforementioned medical history, chronic ear infections, or pre-existing hearing loss, *or* the ear cleaning does not resolve the issue: prioritize seeing a qualified professional to determine if the sudden drop in hearing is related to cerumen at all, as it could also be a sudden sensorineural hearing loss that requires a diagnostic audiogram and swift medical intervention.”


Audiology equipment company, 3M, recently published this blog cerumen removal products regarding the best products to get rid of cerumen (see attached link) but these are just a few. Here is also a review about ear cleaning kits from amazon. Best selling ear cleaning tools on amazon. Of course there are the old drops and ear bulb method, but there is also irrigation, lighted curettes and microsuction tools.


Irrigation


There are several tools using “irrigation” or sprayed water like the

The OtoClear Spray Wash Kit from Bionix is listed for $85.00. This Irrigation system directs water to the ear canal wall gently with three divergent streams, instead of directly at the Tympanic Membrane. The Kit includes the spray bottle, 20 irrigation tips and ear basin.


There are certainly other items on the market, that are less expensive for irrigation, like the Ear Wax Removal Kit by Blue Echo Care. Local Entrepreneur, Ed Wagner, has a few items that he sells on amazon and through e-commerce on his site www.blueechocare.com. These include an Ear Wax Removal Kit that includes a spray bottle, nozzle/hose and ear spiral tips with a washbasin. It is reusable, dishwasher friendly and USA made and not nearly as expensive as other products on the market. For additional information write him at :support@blueechocare.com


Blue Echo Care also has a Cleanse Right Electronic Ear Wax Remover -which is a little more expensive, listed for $55.99. This kit INCLUDES: Electronic Ear Wax Removal Device with 3 separate speeds and pulse to allow you the best possible options for ear wax removal, Charging cord, USA Made Ear Drops, USA Made, Reusable, Dishwasher Friendly Tips with Splash Dish. It is marketed as a revolutionary device in the field of ear wax removal blockages. Much like the renaissance of the toothbrush in the early 2000s with the advent of the electronic vibrating toothbrush, The Cleanse Right Electronic Ear Wax Remover has changed the way 12 million Americans deal with Ear Wax Removal.



Microsuction


For micro suction, E3 has a top pick of the Baron suction tool in size 7 which would have to be purchased with the suction machine kit . This is surgical-grade stainless steel tools that is to be used with a head-worn lighting and magnification to see where you are working. There is also the Bionix Lighted Suction Tool. Bionix Lighted Suction combines illumination and magnification with the efficiency of a suction device, allowing healthcare providers take less time to see and safely remove ear canal and nasal passage obstructions.

This is worth checking out, especially for the new or traveling clinician. This single-use device provides magnification and illumination within the instrument, making it an easy all-in-one product. It should be noted that these should be used by a trained professional and people using these devices should use caution inside the ear.


Lighted Ear Curettes

For another method and probably the most common in Audiologists and ENT offices are using a lighted ear curette system. This could be like the Lighted Flex loop system which is listed for $99.00. The Bionix system Bionix Curettes use illumination and magnification to make it more efficient to find and safely remove cerumen from the ear canal. All versions include 1 Light Source and 1 magnifying lens.This is scoopng system to safely remove ear wax from the canal.


Amazon lists a bunch of cell phone capable, Ear wax removal camera tools that use bluetooth to hook up with your phone. LIMINK Ear Wax Removal Camera is one- listed for for just $15.99 also, Brand: JUSTKIT Ear Wax Removal Endoscope, Earwax Remover Tools, Ear Scope9, with 1080P FHD Camera, 6 Led Lights, Wireless Connected, Compatible with iPhone for $ 21.99. These are a little electric toothbrush sized endoscope with camera light and mini scraper that you can scoop your wax out with a little scope.


Overall, there are lots of ways to safely remove unwanted earwax. As stated earlier, Cerumen should be self-cleaning but that isn’t always the case. It should be understood that if there are any risks like diabetes or any immunocompromised situations or people who take blood thinners, there are risks associated with digging around in ear because there are risks of bleeding and abrasions. If the tool being used, isn’t sterilized properly, you could be introducing possible infection. When Cerumen is impacted, you should visit a health care professional and they can refer you to an ENT (Ears, nose and throat) doctor or an Audiologist.


For additional information from the National Institute of Health (NIH) about Cerumen managment, read this article and remember ear health is important, take care of your ears! Here’s another resource too https://journals.sagepub.com/doi/10.1177/2150132720904181

-Radha Joy, Pepp Now CEO and Leader in Occupational Hearing Conservation

Questions? radha@peppnow.com



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