Before you book...

We can see anyone 18yrs old and over who needs routine ear wax removal, but we can't see you if you have any other medical ear conditions such as:

• Perforated ear drum or recently healed (within the last 90 days)
• Severe ear pain within the last 30 days.
• Ear infections.
• Active excema causing pain, swelling or discharge.

If you have any of the following, we can proceed with but with caution.                                                                                                                             

• Troublesome tinnitus that effects your life.
• Troublesome vertigo or dizziness that is recurring or current.
• Using any blood thinning medication such as warfarin or asperin.
• Have a blood clotting condition such as haemophilia.
• If you have had wax removals in the past that has lead to complications such as pain verrtigo or tinnitus.

Prior to commencing the procedure, your clinician will discuss with you the benefits of removing wax from your ears.

In order to check that it is safe to proceed you will be asked some questions about the health of your ears and general health. It will also be necessary to carry out a detailed visual examination of your ear/s and the wax present. If safe to do so, and clinically necessary, wax will be removed from your ear/s using the most appropriate method according to the quantity and consistency of the wax discovered.

Pre-Procedure
You may be advised to soften the wax with olive oil prior to your appointment. Your ear/s may feel  blocked following application of an ear wax softener due to the expansion of the wax. If you are a

hearing aid user, it can be advisable to avoid wearing the hearing instrument/s when olive oil has recently been administered, therefore overnight application of an ear wax softener may be best.

Procedure
Two methods of wax removal may be used during your appointment, suction and/or manual extraction.

Removal of wax deposits using manual extraction instruments.
Fine hand-held instruments are inserted carefully into your ear and used to gently extract the wax from the ear canal. These will not be used when the wax is deeply situated in the ear canal.

Wax removal using suction
Wax is removed from the ear by a small suction tube. This procedure can be noisy.

Risks
Your clinician has undertaken training and is certified as competent in ear care and wax removal and will use best-practice procedures to minimise any risk. However, even when performed with the utmost care, there are some risks involved in wax removal.

These risks include:

Uncommon

• Discomfort / pain (minimised by application of olive oil prior to appointment)
• Damage to skin of the ear canal (minimised by application of olive oil prior to appointment)
• Bleeding from ear canal
• Ear infection (minimised by water precautions post procedure)
• Temporary reduction in hearing
• Temporary hearing sensitivity
• Temporary aggravation of existing tinnitus
• Temporary irritation to the throat or stimulation of cough

Rare

• Feeling sick or light-headed
• Temporary dizziness

Extremely rare

• Permanent hearing loss (minimised by limiting time of exposure to noise of suction machine and avoiding contact with or trauma to the ear drum)
• Triggering of new tinnitus (minimised by limiting time exposure to noise of suction machine)
• Damage to the ear drum during the procedure (minimised by restricting the depth of insertion of the suction tube)

PVP Shunts
You may be offered a hearing check during your appointment. Guidance from the British Society of Audiology suggests this poses a significant risk to any patient who has a PVP Shunt fitted.

If you have a PVP shunt you should decline the hearing check and ensure your clinician is aware that you cannot wear the headphones.

Outcomes
If the wax cannot be removed
Depending on the amount and consistency of the wax and your own comfort, it may not be possible to remove all of the wax in a single appointment. A second or third appointment may be required with further softening of the wax for a few days between visits using alternative softeners as advised.

Onward referral
In some situations, wax removal may be deemed unsuitable or need to be abandoned during the procedure. Most commonly this is because abnormalities of the ear are identified which require further assessment by your GP or an ENT specialist, making it inappropriate to proceed. It may be necessary to refer you following the procedure for a follow up with a medical professional either directly (or via the “Tympa Cloud” Remote Review system) for further management, advice, or a second opinion. Most commonly this is because:

• Evidence of current or recent infection has been discovered
• Evidence of current or previous damage to the ear has been discovered
• The wax removal procedure has made you feel unwell
• The wax has proven to be too difficult to remove safely or without causing discomfort
• A foreign body has been discovered in the ear which cannot be removed safely

Media recorded
Before, during and after the procedure your clinician will record images and videos within your ear/s. This media may be used for the following reasons:

• To request further advice or a second opinion from another suitably qualified medical professional
• Training and research
• To ensure you, the patient, are as informed as possible

Aftercare
Keep ears dry for a minimum of 24 hours after the appointment. It can be helpful to use a cotton wool ball in the entrance to the ear canal  with some petroleum jelly when showering. Inform your clinician and seek advice from an appropriately qualified medical professional immediately if any discomfort, pain, swelling, discharge, odour or disruption to your hearing is experienced following the procedure.

CONSENT
You will be asked to sign on the Tympa system a summary of your consent as outlined below:

• I have read the information above and understand the benefits and risks involved
• I understand the alternative options for wax removal
• I give my consent to allow the clinician to remove wax from my ear, using the most appropriate method for the amount and consistency of wax discovered.
• I understand that the removal may take more than one appointment and that it may be necessary to refer me to a medical professional if any complications arise.
• I understand I can ask the clinician to stop the procedure at any time, for any reason. I agree to follow the aftercare advice given.
• I give my consent for images and videos of my ear/s to be taken during the appointment.