Expert: Harriet B Jacobster, Au.D. - 7/30/2008

Question
QUESTION: Hi Doctor,
For the past 3 years, about once a year my right ear will develop a wax plug and will give me a bit of tinnitus, I am 24. When it happens I go to the doctors to get my ear syringed, but I wonder why its been happening?, I dont clean my left ear anymore than my right and cleaning habits haven't changed. I don't use canalphones.

I don't like using q tips, and audiclear(otc irrigation) is very weak and doesn't seem to do much.

I live in Sydney Australia and our tap water isnt that good compared to other developed cities but I am wondering if I can self irrigate in the shower, my shower head can turn and make a single stream of water like a tap, I tried to use this as irrigation for my wax plug but it only pushed it in further, I think its against my eardrum now, I will be going to the doctors today.

Although I am wondering if irrigation in the shower once a week would make for good regular cleaning? I tried it in my left ear today and I did feel it tickle what I think is my eardrum.

ANSWER: Hi Michael,
Some ears are just more prone to wax buildup than others...even in the same person.  It can be that the glands in that ear are more overactive, or your canal may be more curved and thus harder for the wax to be pushed out.  In any case, there are several things to do: first, instead of going once a year for a cleaning, try going every six months.  This prevents the wax from getting so bad as to push against your eardrum.  I do not recommend using the shower to irrigate your ears; the force of the water is too strong and can actually puncture your drum.  Additionally, if you do not properly dry your ears, you will get fungal infections.  Instead, there are many over-the-counter wax mangements systems that are available which contain a cerumenolytic which help to soften the wax for easier removal and a bulb syringe to gently irrigate the ear.  Just make sure that you have no perforation of the eardrum prior to using these. You may also want the ENT or his nurse to instruct you on the proper usage of the system.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology

---------- FOLLOW-UP ----------

QUESTION: Hi Doctor,
I went to see a GP who cleaned out my ears with a syringe. My hearing felt imediatly better but my eardrum still hurts, its been hurting for about 3 days now. I am worried about perminent damage although there is no ringing and the pain on a scale of 1-10 is about 2.

Answer
Hi Michael,
Did the doctor have difficulty removing the plug?  Was it deep?  Did the doctor give you any medication to put in your ears?  A lot of times, the ear will hurt for a while after wax removal especially if the wax was hard and deep.  My biggest concern with syringing is that the eardrum can be perforated.  Do you have any drainage from that ear?  If the ear doesn't feel better in another day or so, I would suggest you go to an ENT (ear specialist), NOT the GP and have the ENT look at your ear. There is always a chance that there could be permanent damage, but if you take care of it and have it checked by an ENT, chances are very good that your ear will recover.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology