Earwax Removal

ear endoscope

What is Ear Wax Removal?

Ear wax removal is a commonly performed procedure at Allergy & Sinus ENT Specialist Centre, Head & Neck Surgery Singapore. It is important that you seek an ENT specialist to ensure the right procedure is conducted if you are suspected of impacted ear wax. Too often patients make the mistake of seeking the wrong method of ear wax removal or attempting to remove ear wax by themselves. This could result in injuries to the ear, which may worsen your ear condition. 

ear wax
Ear wax removal should be performed by an ENT specialist to ensure safety and prevent exacerbating the condition.

There are three ways in which ear wax removal is performed. The suitability will depend upon:

  • The amount of ear wax buildup 
  • Underlying health condition 
  • Identification of infection in ears

Upon assessing these factors, an ENT specialist will determine the best-suited method to conduct ear wax removal. Below is a table detailing different methods and factors of consideration. 

Ear wax removal method Factors of consideration 
Microscope & suction This method is most often performed with a microscope and suction. This is the safest option as it allows direct visualisation of the ear canal with magnification to ensure safety. It can be considered when patients have an ear infection or underlying conditions of eczema, psoriasis, and seborrhoeic dermatitis. Suction is typically reserved for those with soft wax.
Microscope & MicroinstrumentationTypically necessary for those with dry or hard wax. This method is suitable if the patient’s ear canal is narrow, and the eardrum has a perforation or tube. 
Manual ear irrigation This is most often performed in GP clinics. While it may be effective in certain instances, it lacks the precision and effectiveness of the above-mentioned methods which involve the use of a microscope. This method cannot be conducted if patients are found with damaged eardrums or tubes, underlying immuno-compromised conditions, and if there is an active infection in the ear canal. 

How does Ear Wax Removal work?

Firstly, your medical background will be evaluated through history taking to ensure the correct diagnosis. Then, the best method is chosen to address the impacted ear wax condition. It is important that patients declare any underlying health conditions before the procedure. Additionally, you will be asked about any presentation of symptoms such as pain, itchiness, or ringing in the ear. 

Next, a physical examination will be conducted using an otoscope or an endoscope (see photo below)  to gain a clearer visualisation of the ear canal and to confirm the diagnosis of ear wax. Upon evaluation,  you will be informed of the diagnosis and the best method to remove the blockage. 

Oftentimes, it is only after an examination that it becomes apparent that the diagnosis is something other than impacted ear wax, such as ear infections, or rarely other conditions such as ear cholesteatoma or tumours. 

ear endoscope
Examination with an endoscope allows excellent visualisation of the external ear canal and the ear drum. This can be seen by both the doctor and the patient to understand the nature of the ear condition.

Microsuction Method 

Under microscope visualisation, a microsuction tube will be used to first dislodge and then “vacuum” the buildup out of the ears. This is arguably one of the fastest and most requested procedures among our patients. However, it is not necessarily effective for all patients.

Microsuction would be suitable if you have a history of a ruptured eardrum, prior ear surgery, the presence of foreign objects in your ear, or a mild infection. It also brings much relief to those with dermatological skin conditions. 

ear microsuction
Microsuction involves the use of an ear microscope to provide excellent magnified visualisation while using precise suction instruments to dislodge and remove the impacted ear wax or to treat an external ear infection.

Microinstrumentation & Removal of Ear Wax in Singapore

Using microinstruments under microscope guidance would be necessary if the wax buildup is solid, dry (instead of soft or wet), and stuck deep in the ear canal. It can be dangerous to attempt to manually remove ear wax on your own, so always seek professional help to have this procedure done. This procedure is conducted with tools such as micro forceps, micro hooks, or picks. Very occasionally, if the wax buildup is too hard, you may be advised to administer some ear drops at home to soften the wax. You will then be asked to return on a different date to have the removal done. 

Ear Irrigation method

This method is conducted using a syringe with warm water and saline or diluted hydrogen peroxide. The pressure from the syringe helps dislodge the ear wax buildup and will subsequently flow out from the ear canal and into a basin. Ear irrigation is suitable when the wax buildup is made up of soft wax and there are no infections or underlying health conditions that will be exacerbated by water. This procedure may take up to 10 minutes.

This method is performed in most GP clinics and may be effective for some individuals. However, this technique lacks the precision of the above methods using the microscope. Without direct visualisation of the ear canal, ear syringing sometimes fails to clear the ear wax. Instead, it may occasionally paradoxically cause an increased sensation of ear blockage or increased ear pain. 

Ear irrigation
The ear irrigation method utilises pressure from the syringe to wash out wax buildup.

Benefits of Ear Wax Removal in Singapore 

  • Clearer hearing 
  • Reduces itch and discomfort 
  • Reduces social embarrassment due to odour or leaking earwax 
  • Reduces risk of infections 
  • Safe and effective 

What conditions can Ear Wax Removal treat?

You may be advised to perform ear wax treatment for the conditions below: 

  • Earache from infection (occurring with ear wax simultaneously)
  • Ringing in the ear (tinnitus
  • Impaired hearing, causing hearing loss
  • Odour
  • Discharge leaking from ears
  • Persistent itching  
  • Dizziness 
  • Persistent coughing
Ear wax removal can be used in the treatment of earaches, tinnitus, and impacted ear wax.

What results can I expect from Ear Wax Removal in Singapore? 

Upon completing treatment, one can expect symptoms such as blocked ear sensation or hearing loss, itchiness, leakage from wax discharge, odour, cough, and earache to be alleviated. Every patient reports instant relief and reduced discomfort after an ear wax removal treatment. If an infection is identified, you will be given appropriate treatment, including antibiotics to improve your condition. 

Additionally, if there are concomitant signs of dermatological conditions such as eczema, psoriasis, or seborrhoeic dermatitis, you will be referred to a dermatologist to ensure appropriate and timely management can be conducted. 

How many treatment sessions of Ear Wax Removal do I need?

Usually, a single session of ear wax removal will be sufficient. In the event overproduction of ear wax is identified, you may be advised to return after 6-12 months following the initial visit. It is important that you do not insert any instruments including cotton buds into your ear canals, which may aggravate the ear condition. 

Most importantly, following treatment in the ENT clinic, you will be taught appropriate measures on how to keep the ears free of recurrent impacted ear wax at home, independently. 

Frequently asked questions 

Why should I choose an ENT specialist to have my ear wax removed?

ENT specialists, also known as otolaryngologists have undergone additional years of post-graduate medical training to treat medical conditions of the ears. Sometimes, ear impaction may be a symptom of an underlying medical condition which requires immediate intervention. By choosing an ENT specialist in Singapore for your ear wax removal, you are more likely to find a resolution to the causes of your ear wax impaction. 

Can I use ear candling to remove ear wax?

There is currently no scientific evidence that the ear candling method of removing ear wax is effective. In fact, you are more likely to cause more harm than good. Some of the risks affiliated with ear candle treatments are burns, obstruction or blockage of the ear canal caused by dripping wax, perforated (torn) eardrums, hearing loss, and outer ear infection. We firmly advise against this treatment method. 

Are cotton swabs and buds actually bad?

It is not recommended to use cotton swabs or buds to clean the ear canals. Complications occur when patients dig deep into their ears, pushing the wax buildup closer to their eardrums. Additionally, some patients also present with cotton debris from the swabs in their ears and injury to the intricate structure of their ears. Regular usage of cotton buds causes impaction of the ear wax deep in the ear canal, while also causing drying of the ear canals, resulting in an increased risk of ear infection and ear itching.  If your ears are persistently irritated, get a wax removal done by an ENT specialist, instead of attempting to remove it yourself.

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
Consultant ENT Specialist and Surgeon
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