Ear flushing and ear irrigation

What to know about ear flushing and ear irrigation

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.

Why do I need an ear irrigation?

Ear wax irrigation is not always necessary. It is usually performed after an otoscopy that detects a blockage due to ear wax or other substances, which obstruct the ear canal, causing one or more of the following symptoms:  ringing in ear, feeling of plugged ears, pain in the ears, dizziness, booming sensation of one's own voice. 

Earwax build up & blockage

Earwax blockages are quite common in patients of all ages. It is an obstruction of the ear canal that occurs when earwax, whose job it is to protect and lubricate our ears, builds up. Once the earwax accumulates overtime, it can form a blockage which hardens over time triggering the symptoms described above, such as pain and hearing loss. Irrigation can solve this problem.

Presence of foreign objects in the ear

Ear irrigation can treat more than just an earwax blockage, it can also eliminate the presence of other elements that have entered the ear canal. In children, for example, this can be beads, pebbles, small pieces of toys or paper balls; in adults, it can be parts of cotton buds, sand or even insects that have accidentally entered the ear.

How do ear irrigation and flushing work?

Ear flushing is an outpatient procedure that consists of a few steps: a preliminary otoscopic examination, application of ear drops and the irrigation of the external ear canal, which serves to remove the earwax or any other substances that may be trapped in the ear canal. 

Step one: look inside the ear

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.

Step two: choosing the right tool

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.

How long does ear flushing last?

An ear flushing procedure can be repeated several times, or until the blockage has completely disappeared. It is a fairly short procedure that takes approximately 15 to 20 minutes. 
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Ear irrigation side effects and risks

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.

When ear irrigation should NOT be carried out

Irrigation of the eardrum is not recommended when the patient suffers from otitis or if the patient has a perforated eardrum. 

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Ear Irrigation: cost & financing

An ear irrigation procedure generally costs the same as a visit to an ENT specialist.

Does insurance cover ear irrigation?

Most insurance plans will cover a set of preventive services. Depending on your plan, your insurance may cover all or part of the cost of the procedure.

How much does ear irrigation cost?

The cost for an ear irrigation procedure can vary greatly depending on the centre where the procedure is performed and the treatment method. However, the price ranges between 50 £ and 100 £. 

How can I flush my ears at home?

Do-it-yourself ear irrigation is not recommended, it is best that the procedure is carried out by a trained professional, given the sensitivity of the organ and the risks that can arise. If the obstruction is superficial, you may attempt to irrigate ears at home with the help of ad hoc instruments.

Irrigation Kit

Various ear-washing kits are commercially available, consisting of needle-free syringes or small straws through which sterile water or a saline solution at body temperature can be gently inserted into the ear duct. Cerumenolytic sprays, which are intended to dissolve earwax and facilitate its removal, can also be used.

Alternative remedies for ear irrigation

There are also natural and alternative methods for removing earwax. For example, dissolving earwax with a saline solution or with a few drops of warmed up olive oil or sweet almond oil, which could help dissolve the earwax and promote its removal. Lastly, chewing or moving the jaw can also promote the exit of old earwax from the ear canal: as the earwax approaches the ear opening, it dries out and leaks out. It can be removed with a soft cloth or cotton ball.

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