Ear Syringing, Irrigation and Tinnitus — What Damage Is Incurred?

Hi all,

Although it's not one of the most common causes, it appears as though quite a few people got their tinnitus following syringing or irrigation of the ear with water to remove ear wax. It also appears that a few got it following microsuction to remove earwax, particularly if eardrops were not used before wax removal.

It's easy to imagine how the noise of microsuction might cause acoustic trauma in the ear in a few cases, perhaps if suboptimal technique is used or the wax is too hard.

But how could simple irrigation, in particular, cause tinnitus? Would the eardrum have to be perforated? Has anyone looked into this or does anyone have a few thoughts on it?

 

Any treatment that involves inserting something into the ear will incur some risk however small of damage. this is particularly the case with wax removal by syringe or micro suction. if you suspect that wax may be present in your ear using drops to loosen the wax might be a safer option ( some people recommend hydrogen peroxide but I am not sure that is a good idea) Don't try syringing your own ear,

 

If the right precautions and procedures are carried out before ear irrigation or microsuction problems don't usually occur. I have had ear irrigation three times without problems and microscution three times without problems. My tinnitus varies from: complete silence, mild, moderate and severe. Please read the post below.

Microsuction and Irrigation.

The ear is a delicate and sophisticated organ that some people might not give much thought to, as the majority of the time it’s able to take care of itself, until something goes wrong with it. Attached to the side of our head we see the outer ear known as the Pinnia.

The Pinnia collects sounds from the outside world and funnels them down the narrow passageway inside our head called the ear canal. The sounds are directed onto the eardrum which is situated in the middle ear. The ear canal is lined with wax the medical term cerumen. Small glands in the ears produces the wax and protects the skin of the canal by preventing bacteria, dirt and other foreign substances from entering. Under normal circumstances the wax passes out harmlessly but sometimes a build up can make the ears feel blocked and one might experience hearing loss, itchiness, sometimes pain and even tinnitus.

If using eardrops doesn’t clear the blockage a visit to the GP surgery for removal of the wax using irrigation might be necessary or in some cases going to an ENT clinic for microscution.

A few people have contacted me and raised concerns about irrigation and microsuction and asked whether they are safe for use on people that have tinnitus? I also had a lengthy discussion with someone in this forum last week, who’s adamant the tinnitus was made worse after having microsuction. This person had done all the right things. Applying olive oil eardrops to each ear for two weeks prior to the procedure and still ended up with problems. I therefore believe, the health professional doing the microsuction, wasn’t as skilled and adept as he or she should have been. This is unfortunate, as the person in question had no way of knowing this and is now enduring more discomfort.

The old fashioned method of ear syringing, using a metal canister filled with water and squirted into the ear under pressure, to remove earwax is no longer used. This method was rather crude and abrasive and could cause problems to the ear. Modern ear irrigation is considered gentler and a safer method. I have had this done three times at my GP surgery without problems. Prior to it being carried out I used eardrops 3 times a day for 10 days to soften the wax.

When the earwax is impacted irrigation might be unsuccessful even after using eardrops. The next step is microsuction. As the name suggests, the wax is literally sucked out using a small handheld wand with a suction tip and is considered to be the safest method of wax removal. I have also had this done three times at my hospital ENT department, which was carried out my consultant who I had every confidence in and had no problems. She is a firm believer in the use of microsuction especially for someone with tinnitus. Again, eardrops should be used for 7 to 10 days before having it done.

A word of caution. Type into any search engine and you’ll probably find a mirosuction clinic in your area, advising how safe and quick it is and that there’s no need to use eardrops to soften the wax. Others might say just use it for a couple of days or the night before coming into clinic. I strongly advise you not follow this advice. People have contacted me after having microsuction and didn’t use eardrops for 7 to 10 days and ended up with tinnitus that they didn’t have before. When they returned to the clinic to complain they were quickly shown the door.

Every medical procedure carries a risk no matter how small. It is just not ideal to go around with blocked up ears, hearing loss or experiencing increased tinnitus as a result of impacted wax. If one is paying privately, try to find a reputable clinic and use olive oil eardrops in the manner I’ve stated before having microsuction or irrigation. I also advise to use eardrops two or three times a week to keep the earwax soft so it can pass out through the ears naturally and help prevent build up.

Michael

 

Thank you Michael, I had previously read your excellent piece on the subject of wax removal procedures

I emailed the author of one of the very few papers on the risks of tinnitus following the various methods of wax removal and he me he sent me the following document in answer to my query. The document is well worth reading for anyone interested in the subject.

http://www.clarksvillecenterforaudi...k-of-Complications-During-Ear-Wax-Removal.pdf

The document says:

"As for the loudness levels of these ear-cleaning procedures, excessive pressure is more likely to cause problems than sound exposure. Excessive pressure can be applied with irrigation, suction, or with a curette. In some cases, the ear will translate this mechanical pressure into the sensation of loud sound. Excessive mechanical pressure can damage the eardrum or send shock waves into the cochlea causing sensorineural hearing loss and tinnitus. A gentle, careful approach to ear clean- ing is the number one rule"

The answer to my question would appear to be – mechanical trauma can mimic acoustic trauma

 

@Agrajag364 @pathworker2017 @Michael Leigh

http://hearinglosshelp.com/blog/tin...ng-and-middle-ear-infections-whats-the-score/

 

Hi @Agrajag364 @Greg Sacramento

Thank you for the information on ear irrigation, microsuction and tinnitus. A person has two choices if they have impacted earwax. Either leave it as it is or get it removed. I appreciate that there are risks but I prefer to choose the latter as I've done on six previous occasions. I don't want impaired hearing, risk getting an ear infection, dizziness or making my tinnitus worse which can happen if the wax is not removed.

Michael

 

Do you know if any of the wax on these occasions was on your eardrum Michael?

You are right in what you say on the necessity of getting wax removed but I wish more comparative research had been done on the risks of each method in terms of tinnitus. It is clear there is not consensus amongst experts on the safest method with regard to the risk of causing or exacerbating this symptom

 

Hi @Agrajag364

I can only speak for my ENT consultant who removed the impacted wax which was tight up against my eardrum resulting in me having impaired hearing for around 10 days. I had every confidence in her while she performed microsuction on both ears and took around 30 mins. She had done this twice and I had no problems. The third time I had microsuction was again done at hospital but was performed by a ENT Registrar and I experienced no problems.

The other three occasions I had ear irrigation at my doctor's surgery. I would always have earwax removed by microsuction at a hospital and not a clinic that advertises their business on the Internet. The same applies for ear irrigation. I would always get it done at my GP surgery.

I put my trust in these health Professionals and fortunately haven't had any problems on six occasions having earwax removed and I have quite severe tinnitus.

Hope this helps
Michael

 

I saw an ENT 19 months ago due to a build up of wax in my ears (mainly my right ear) . I had been applying wax removal drops religiously for over 10 days prior to going. The ENT said the wax was soft and performed microsuction on both ears (not just the one that was blocked), the procedure was VERY loud. The following day I had extreme fullness in my ears and loud ringing. In the days following the procedure I noticed a drop in my hearing, sounds seemed muffled and distant. I also developed hyperacusis. This was the start of my nightmare. In my case microsuction caused hearing loss, tinnitus and hyperacusis. Do Not believe that microsuction is safe, even using drops before, it is not. Unfortunately people, like myself, are suffering due to a procedure that is put across as being the safest method of wax removal. I wish I had known about the dangers before, sadly I did not and am paying a HUGE price now.

 

I had a microsuction last week and yes, it was loud and I wasn't sure what to expect. I had an understanding ENT so he explained what the did and when he would start. It took maybe 1-2 seconds to suck the excess olive oil and a little bit of wax out but my major issue was the false fundus I have in my ear (that I thought was wax, hence the oil, it actually made my hearing worse!). It needs to be sucked out tomorrow and even if I didn't get any spikes from the suction last week, it still induces major anxiety in me as I really want to avoid anyone to poke around in my ear. But the mild false fundus that I have must be removed as it is annoying and really, it should not be there. It's just next to the eardrum so suction is the only option. I went to an experienced ENT and the ENT tomorrow is one of their super specialist that seems to be very knowledgeable (see his articles here https://www.researchgate.net/profile/Lennart_Edfeldt) and knows even more than the ENT there about the auditory system so I know I am probably in the best hands that I can be in at this point.

To be fair, my bad ear has become quieter after the suctions as the oil was blocking my hearing and amping up my T a lot. It's still a bit louder than my baseline but I also have some thin skin-like cover on my eardrum so I guess that explains it. Lately, my "good" ear have been louder than the bad one, which is pretty strange (did not have the good ear sucked) so even if there are horror stories, if you go to a good ENT it might not end up with the worst case scenario. Not saying that suction cannot cause damage, indeed it can, but I went to the ENT swearing my hearing would become worse 100% but that is not the case.

 

From personal experience I don't recommend syringing at all. The best way to remove wax is with a curette, I don't know why doctors waste our times with microsuction and with syringing when these methods are really invasive.

 

Just want to say that my tinnitus can be severe and I've had microsuction 3 times and syringing the same without any problems. If eardrops is used 3x a day for 7 to 10 days before the earwax is removed problems won't usually occur. Removing earwax by curette can also cause problems when eardrops are not used as mentioned above.

Michael

 

Unfortunately it didn't work so well for me, I used ear drops 3x a day for 7 days my problem with both proceadures is the pressure, and I felt the nurse and doctor were careful it's just the precision and function of the machinery that is not delicate enough for my narrow ear canals.
As I mentioned above this is just my personal experience I know most people are fine with these proceadures but for me only curette with endoscope/otoscope works, there is no forceful entry with the curette and as long as there's proper handling with the curette there is virtually no risk in the proceadure.
I type this message with the warning that this is just my personal opinion and nothing more, but I also know a lot of stories from people who used eardrops and had a bad experience after doing either microsuction or syringing, however I never found any stories concerning people who had bad experience using curette.

Kind Regards ,
Artur

 

HI @Artur

You may want to click on the link below which is a thread started by @grotulon He had earwax removed by curette and used eardrops for 7 days and had problems:
https://www.tinnitustalk.com/thread...-still-feels-clogged-a-bit-and-muffled.21654/

Michael

 

Michael, you have been very fortunate, in that the procedures have not caused harm to your hearing. I find it dangerous you continuously mentioning to people that the use of ear drops prior to microsuction should be enough to prevent complications. In your case perhaps, but in my case the use of drops did not make any difference. Microsuction is a very noisy procedure, and noise damages hearing. Please stop deceiving people that drops are sufficient to prevent damage. They are not. As I have already stated, my life has been turned upside down by the damage microsuction has caused to my hearing, and this damage was caused despite using drops religiously for over 10 days. There are many variables, including a person's tolerance of noise, the care (or lack of) taken by the person performing the procedure, in my case an ENT DOCTOR (not a clinic). I had NO hearing problems prior to this procedure, now I live with hearing loss, hyperacusis and severe tinnitus. ALL CAUSED BY MICROSUCTION!

 

I have mentioned to you before that it’s unfortunate you had a bad experience with microsuction. I have had the procedure three times and ear irrigation the same without any problems and put my trust in the medical professionals that attend to me. We have discussed this issue on more than one occasion and frankly I’m tired of going over the same things with you and having to repeat myself. Therefore please take note of the following as this will be the last time that I will be corresponding with you, since you have chosen to disrespect me by saying I am deceiving people.

I will continue to advise anyone in this forum that ask for help and will do so to the best of my ability. Whenever I feel it necessary I will recommend microsuction or ear irrigation as the best way to remove earwax. I will always stipulate eardrops should be used 3x a day for 7 to 10 days before the procedure as told to me by me GP and ENT doctors.

Michael

 

There is no need to be so rude Michael, I was simply trying to say that you should be careful what advice you give. I don't believe I was being disrespectful either. However, I stand by what I say about microsuction, it is in my personal opinion, a potentially dangerous procedure. Fortunately for you, your hearing health did not suffer from this procedure, but this is not the case for everyone (I am not the only person on TT who has suffered hearing complaints or tinnitus following microsuction).

Your response "frankly I’m tired of going over the same things with you and having to repeat myself" I find insulting and uncalled for, I am not asking you to repeat yourself or asking for your advice, so there was really no need to say that. I was simply stating that even the correct use of ear drops prior to wax removal doesn't ensure that damage will not be caused.

I am only sorry you feel you have to attack someone simply because they don't agree with your advice. Maybe it's better you have decided you "will not be corresponding" with me again, as I will not change my opinion of the risks associated with microsuction, and it seems neither will you.

Blue

 

When you have your ears suctioned or srynged it is always best to use olive oil drops or alternative drops to soften the wax.
This is to soften up any crusted wax around the drum to reduce redness and inflamation and to ease any pain.
Any procedure can cause risks and I know a few people whom got tinnitus from ear srynging and microsuction and @Markku got tinnitus due to it and won't mind me saying so.
Love glynis