As a hearing care professional, learn to remove earwax safely and with confidence

As a hearing care professional, learn how to safely and confidently remove earwax with the help of microsuction combined with instant vision Among the numerous hearing problems you encounter as a hearing care professional, earwax or cerumen is a common and recurring problem. Earwax is a naturally occurring substance that plays a crucial role in protecting the health of the ear. But sometimes earwax or cerumen builds up and blocks the ear canal, which can cause hearing loss and other complications. As a hearing care professional, if you are unable to remove ear wax yourself, it can seriously disrupt the flow of clients in your hearing care practice. If clients are referred to have their affected earwax removed, you will lose time and revenue and possibly your client:

You lose clients in the referral process because they may visit one of your competitors after ear wax removal to get their hearing aids fitted
Increasingly, your competitor auditors do will remove earwax to improve their customer flow

Be at the forefront of this new development and retain your customers or attract additional customers. Being able to remove earwax at your place of business will save your customers a lot of time and money. After all, it is very inconvenient for them and any caregivers because they need multiple appointments unnecessarily. We advocate that you start earwax removal as soon as possible, and we have the solution for you to get started quickly. This blog will introduce you to earwax or cerumen, what it is and what its function is, the human body’s natural process for getting rid of earwax, which people it is most common in, and safe and unsafe removal practices. We then explain to you our 3 step approach to start removing earwax safely and with confidence. The 3 steps consist of

Professional training (theory)
Approved and recommended equipment and
Guidance in practice (mandatory in some countries)

If you already have a good understanding of earwax and would like to go directly to the last part of the blog, click here.

What is earwax?

Earwax, scientifically known as cerumen, is a natural and waxy substance produced by the ceruminous glands in the ear canal. The primary function of earwax is to serve as protection for the ear canal by trapping dust particles and harmful microorganisms such as insects, fungi and bacteria. In doing so, it prevents these foreign body particles from damaging the eardrum and reaching the delicate structures of the inner ear. Furthermore, it acts as a natural lubricant, cleaning the ear and preventing the skin of the inner lining of the ear canal from becoming excessively dry and itchy.

What types of earwax are there?

Earwax, or cerumen, is a waxy, yellowish substance produced by the sebaceous glands in the ear. The type of earwax a person possesses is genetically determined and linked to the presence or absence of a specific gene known as ABCC11. Earwax manifests itself in two primary types, each with different characteristics.

Wet Earwax (Cerumen): This type occurs mainly in European populations and is usually characterized by its yellow or brown color and its moist, sticky texture.
Dry earwax (scaly cerumen): In contrast, dry earwax is more common in East Asian and Native American populations. It is often gray in color and has a flaky, dry texture.

In addition to genetics, other factors play a role. Think highly stressful lifestyle, chronic ear infections, environment and climate play a role in cerumen formation. Frequent use of headsets and earplugs counteracts venting and breathing of the ear canal, thereby stimulating earwax production.

What is our natural body mechanism to remove earwax?

The human ear is has an innate and remarkable self-cleaning mechanism. As fresh earwax is produced, the older, drier earwax gradually migrates out into the ear canal and eventually finds its way into the opening of the ear. This process is facilitated by actions such as chewing, jaw movements and the natural outward growth of the skin lining the ear canal. In most cases, earwax is naturally expelled from the ear canal without causing problems. When this mechanism does not work as it should, there is a need for external intervention to routinely and correctly remove the excess wax.

Which demographics are most affected by earwax blockages?

Earwax blockage, or cerumen impaction, is a universal phenomenon that affects individuals across the spectrum of age, gender and cultural backgrounds. However, its prevalence may show variations among different demographic groups. Roughly speaking, we can say that this widespread phenomenon is experienced by 55% of seniors, 35% of the disabled, 10% of children and 5% of healthy adults. Earwax impaction is more common in older adults due to changes in cerumen composition and hair growth in the ear canal. Furthermore, it is also more often a problem in men than in women.

What possible complications can an ear wax blockage cause?

Cerumen impingement is the leading cause of temporary treatable hearing loss. Because partial hearing loss gradually increases over time with the development of ear wax, many people are often unaware of it. Hearing loss has a direct effect on quality of life, reduces productivity, increases frustration, leads to behavioral changes and can even lead to social withdrawal. Although earwax is crucial to ear health, excessive buildup or impaction of earwax can lead to a host of complications, including:

Ear pain and discomfort: Ear wax impaction often causes ear pain, pressure sensations and general discomfort in the affected ear.
Tinnitus: Individuals suffering from ear wax blockage may experience tinnitus, a condition characterized by squeaking or buzzing sounds in the ear.
Dizziness and vertigo: In severe cases of ear wax congestion, the balance system may be affected, leading to dizziness or vertigo.

What is the relationship between hearing aids and earwax

People who wear hearing aids often complain of an increase in ear wax. The reason is that hearing aids can stimulate the glands that produce earwax. In addition, the hearing aids themselves, located in the ear canal, block the natural removal from the ear of excess wax. Earwax often blocks the filters of hearing aids and can damage the microphone, resulting in reduced device effectiveness. If your client is prone to repeated earwax impaction and/or uses hearing aids, you should offer routine preventive cleaning.

What are the current professionally used methods for earwax removal?

The methods of earwax removal used by medical professionals are as follows:

Irrigation or spraying out

This technique involves the gentle infusion or gentle injection of warm water, saline solution or diluted hydrogen peroxide into the ear canal to flush away earwax. This method is often used by general practitioners and their assistants. Irrigation puts water under pressure in the ear, which can lead to complications such as eardrum performance and growth of microorganisms in the ear. This method is under increasing scrutiny and in more and more countries is being abolished or restricted to low-risk patients because of complications and resulting lawsuits.

Microsuction

Microsuction is the removal of cerumen by vacuum suction. The cerumen is gently sucked out of the ear. For microsuction, you use a specialized mobile or portable microsuction unit combined with direct binocular vision. Microsuction is the method routinely used by ENT doctors and has minimal complications. It is a minimally invasive procedure increasingly used by audiologists and general practitioners and their physician assistants.

Manual removal

In some cases, earwax can be carefully removed by using specialized instruments such as a curette or forceps. Very important is to use direct vision with a fixed or head-mounted binocular microscope such as the Vorotek O Scope to see into the ear canal with depth and accuracy. This procedure should only be performed by trained professionals to avoid possible injury.

Ear drops

For very hard ear wax, the above procedures are often preceded by the application of ear wax soothing drops. The best ear wax removal drops contain olive oil, peanut oil and/or carbamide peroxide. Because these drops can irritate the sensitive skin of the eardrum and ear canal, they should be used only upon instruction.

What are unsafe earwax removal practices?

Many methods are used “at home” to remove earwax. We will highlight a few here to highlight the potential problems and complications.

Cotton swabs

In general: Never try to dig out excessive or hardened earwax with things like a paper clip, cotton swab or hairpin. You can push the wax further into your ear and cause serious damage to the very sensitive lining of your ear canal or eardrum. In some countries, cotton swabs are even banned by official regulatory organizations because of the danger involved.

Ear candles

Another method to mention is ear candles. Ear candles involve lighting one end of a hollow, cone-shaped candle and placing the other unlit end inside the ear. The heat from the flame will create a vacuum that pulls earwax up and out of the ear. Ear candles are a very ineffective and potentially dangerous method. It can lead to injuries, including burns and punctured eardrums.

Essential oils

Essential oils, such as tea tree oil or garlic oil, are also not a proven treatment for ear wax blockage. There is no data showing that they are safe for earwax removal or that they work.

How earwax management laws differ from country to country

Throughout Europe, there are variations in earwax management practices, stemming from cultural differences, health care infrastructure and legislation, and regional preferences. In countries such as the Netherlands, ear wax removal is a medical treatment that must be performed by the ENT doctor or general practitioner. Germany has just opened up ear wax removal to the audiologist, provided he or she is professionally trained. While in countries like the United Kingdom, ear wax removal is largely unregulated and even done in beauty salons. If you want to remove earwax in a country like the Netherlands, you have to undergo professional training, use the right equipment and work under online ENT supervision. We offer the complete solution for the audiologist below.

What are the benefits of ear wax removal by a hearing care professional?

The benefits of offering ear wax removal by the hearing care professional are:

Capacity utilization: referral means an appointment with no revenue while occupying a treatment room
Delay in revenue stream: because referrals are made, a hearing aid may not be fitted until later upon return
Customer retention: referrals can lead to eventual customer loss to competitor
New customer flow: the number of people with a regular earwax problem is growing and represents a new commercially attractive customer group

In the Netherlands, earwax removal by hearing care professionals is still in its infancy. We are the first providers of a total solution. Seize the opportunity and be a pioneer in this market.

What are the risks of ear wax removal and how do you minimize them?

In general, ear wax removal by microsuction or curettage under direct vision is safe and complications resulting from the treatment are very rare. Risks lie more in accurately recognizing problems that need to be referred to the medical specialist. Failure to refer can lead to delays in treatment that can worsen the client’s situation, which in turn can come back on you. Therefore, professional training and supervision in the practice is very important.

How do I remove earwax professionally as an audiologist?

The following 3 steps will help you learn to safely and confidently remove earwax:

Follow professional training

We offer on- and offline professional training for individual audiologists and in-company training for audiology chains. Developed by universities in the United Kingdom and Australia, these trainings have been tried and tested and are highly effective. Read more about the training courses we offer here.

Purchase the right equipment

It is important to work with the right tools. Our equipment is carefully selected based on experience by ENT specialists, audiologists and professional nurses. The most important tools for the audiologist: – Direct binocular head-worn vision so you can have your hands free and remove ear wax with depth and accuracy of vision Read more about the Vorotek O Scope here – A reliable and safe microsuction unit with a good price/quality ratio for the right vacuum suction power at minimal noise level Read more about our microsuction units here -. A video otoscope so your customer can witness the wax removal and you can complete the customer file with before and after pictures and videos Read more about our video otoscopes here We also offer all necessary consumables and disposables such as currettes etc.

Online practice guidance

In those countries where wax removal is the exclusive domain of the medical profession such as the Netherlands, the audiologist can remove wax only under medical supervision. In other countries, audiologists may be more comfortable if the online ENT surgeon is available to discuss and resolve any questions or complications. We offer online ENT supervision as part of the training and after the training as a supervision subscription model. Read more about the online ENT support that offer here

Do you have questions as a result of this blog? Then give us a call, whatsapp or email.