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Clearing the Air - Microsuction VS Syringing

Introduction:

Earwax build-up can be uncomfortable and even cause temporary hearing loss. Fortunately, there are various methods available for removing earwax.


Ear syringing, although now uncommon, is still used by some providers for earwax removal.


In this blog post, we will explore the differences between microsuction and ear syringing, and highlight why microsuction is the safer option, backed by statistics and expert opinions.



What is Microsuction?

Microsuction is a non-invasive and precise earwax removal technique. The clinician will wear a head-loupe to examine the ear canal under magnification and will carefully suction out the earwax using a fine tube.


Microsuction is a controlled and targeted process that ensures the removal of only the excess wax without causing any harm to the ear canal or eardrum. Earwax helps to protect the ear, and microsuction allows the clinician to leave residual, healthy earwax behind, rather than stripping out the natural protection system of the ear canal.



Understanding Ear Syringing:

Ear syringing involves using a syringe to flush the ear canal with water to dislodge and remove the earwax. While it was once the most common method used by general practitioners, it comes with potential risks, particularly when performed improperly or without appropriate training. The forceful nature of the water stream may push the earwax deeper into the ear canal or even cause damage to the sensitive structures inside the ear. Furthermore, water can carry harmful bacteria, of which can make a follow-up ear infection more likely.


Is Microsuction or Syringing safer?

Precision and Control:


Microsuction allows the specialist to have a clear view of the ear canal while removing earwax. This level of precision ensures that only the excess wax is removed, reducing the risk of touching the eardrum or causing injury.


On the other hand, ear syringing does not offer the same level of control, potentially leading to accidental injury or improper wax removal.


Reduced Risk of Infection:


The water used in ear syringing can carry harmful bacteria, which may increase the risk of infection. Microsuction, being a dry procedure, eliminates this risk, making it a safer choice, especially for individuals prone to ear infections.


Furthermore, many tools used in microsuction are single use (e.g. The suction tube, specula and rosen). After each procedure, they are disposed of as clinical waste. This eliminates risk of cross-contamination between patients.


Wax Depth and Impaction:


Statistics show that ear syringing may lead to a higher incidence of impacted earwax compared to microsuction. When water is forced into the ear canal, it can push the wax further in, causing blockages. In contrast, microsuction avoids this issue by gently extracting the earwax using suction, preventing it from being pushed deeper into the ear.



Studies and Expert Opinions:

Several studies support the notion that microsuction is a safer and more effective method for earwax removal compared to ear syringing. Researchers have found that ear syringing can lead to complications such as otitis externa (outer ear infection), perforation of the eardrum, and residual wax impaction. In contrast, microsuction has been praised for its safety and precision in removing earwax, with minimal risk of complications.


A survey by Sharp et al estimated complications occur in 1 in 1000 ears irrigated, with the most common complication being failure to remove wax (37%), outer ear infection (22%), perforated ear drum (19%) and damage to the ear canal (15%). Other noted complications include pain, vertigo, and otitis media (middle ear infection).


A further study by Bruins et al estimates that the risk of otitis externa (outer ear infection) after syringing to be 3%. Although this seems small, it equates to 69 000 additional cases of otitis externa per year in England and Wales.



To Conclude:

While both microsuction and ear syringing can be used for earwax removal, the statistics and expert opinions highlight the clear advantages of microsuction in terms of safety and efficacy.


If you are experiencing earwax build-up, it is crucial to consult with a qualified healthcare professional who can perform microsuction and ensure the gentle and thorough removal of excess wax without compromising your ear health.


Remember, your ears are precious, and it's essential to choose the method that prioritises their well-being. Choose microsuction for safe and effective earwax removal.



References:

Radford, J.C. (2020) Treatment of impacted ear wax: A case for increased community-based microsuction, BJGP open. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330231/ (Accessed: 27 July 2023).





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