Endoscopic Ear Wax Removal

An alternative to micro-suction is endoscopic ear wax removal,  it is quicker and easier to perform than micro-suction.  To perform endoscopic ear wax removal an oto-endoscope is used. This a more advanced medical ear torch than the conventional otoscope used by audiologists and doctors to inspect the ear. It is a rigid small diameter fibreoptic telescope to provide an incomparable ‘wide’ and high-resolution view of the ear canal. This makes it both comfortable and safe since it allows it to be rested in the ear canal and allows visualization of the whole ear canal and eardrum with minimum manipulation of the patients head.  The other hand use the suction probe to gently remove the wax or to use other ENT instruments as required.

A 2010 Health Technology Assessment by AJ Clegg et. al. concluded that endoscopic ear wax removal is superior to microscopic wax removal – microscopic wax removal uses an operating microscope or surgical loupes to get a magnified view of the ear canal and ear drum – a speculum (small funnel) must be inserted into the ear canal in order to provide a view, and the speculum takes up some of the space within the ear canal, further restricting the practitioner’s view. Furthermore, the speculum can sometimes cause minor trauma to the skin of the ear canal if the ear canal is very narrow.

How Does it Work?

In contrast, endoscopic ear wax removal uses a fine 2.8mm endoscope inserted part way into the ear canal. The endoscope is a rod containing fiber-optics to relay light from a light source to illuminate the canal and a solid lens (or series of lenses) to relay the view from inside the canal to the outside. The endoscope can be either viewed directly, or imaging equipment can be attached to provide better magnification

Side Effects and Risks

As with micro-suction, endoscopic ear wax removal can be noisy. There is a very small risk, as with all other wax removal treatments, that some people may report tinnitus or increased tinnitus if they already experienced it pre- ear wax removal. There is a small chance of slight bleeding due to grazing and scratching the ear canal with the suction probe. However, compared to micro-suction, this risk is further reduced because there is more operating space available.  Secondary trauma of the eardrum caused through the oto-endoscope, suction probe and other ENT instruments is also albeit rare.  As with micro-suction the ‘caloric effect’ is possible due to the cooled air currents created by the suction machine, this may cause a temporary dizzy feeling which passes after a few minutes.