Ear irrigation, also known as ear flushing, is a procedure that aims at removing residual or excess earwax and other substances from the ear canal. It is a painless procedure usually performed during a visit to an ENT specialist to prevent or resolve the formation of earwax plugs, swelling or other conditions that may temporarily or even permanently damage a person’s hearing ability.
The otoscopic examination is the first procedure to be performed. It is performed in the ENT clinic and it is used to recognise the possible presence of earwax or other substances obstructing the ear canal. The doctor uses an otoscope, an instrument consisting of a light bulb that illuminates the external ear canal and the eardrum, a magnifying glass and an ear speculum, which is inserted into the eardrum to get a clear view of it.
Sometimes, an optical microscope is used to get more depth of field. This is a fundamental step because, by performing this examination, the specialist can understand extent of the obstruction and choose the most appropriate procedure to remove it.
Once an earwax blockage is diagnosed, the ENT specialist proceeds to remove it by irrigation with sterile water or a saline solution. If the blockage has hardened, emollient drops are used to soften it and facilitate its removal. Only at this point the irrigation procedure of the external ear canal can begin. It should be performed using lukewarm water, to avoid trauma to this very sensitive and delicate organ, using an ear irrigation syringe without a needle.
At the end of the procedure, the patients tilt their head slightly to encourage the material to come out. Depending on the size of the blockage or the obstructing element (which can also be insects or small rocks), the doctor can also use Hartmann's forceps or a water pump as an alternative to the syringe.
Other methods used include a D&C procedure, which involves the use of a curette, i.e., a stick curved at the end, which mechanically removes the plug. Suction is also effective. In this case, a straw connected to an aspirator is used to suction the earwax and remove it more easily.
Although ear irrigation is a rather simple and painless procedure, if it is not performed with caution, given sensitive area, it can pose several risks. In fact, it is essential to avoid water stagnation, which can cause infection and inflammation. For instance, if water gets trapped below the remaining earwax, the patient may develop external otitis.
Additionally, the liquid injected by the syringe must exert sufficient pressure to remove the blockage. Excessive pressure can cause injury to the eardrum. If the water temperature is not at body temperature, complications such as dizziness, bradycardia and nausea may occur.
Irrigation of the eardrum is not recommended when the patient suffers from otitis or if the patient has a perforated eardrum.
