Removal of ear wax

• If your ears feel blocked, it’s usually best to get examined by a doctor first.
• Ear wax is common, but there are other causes of blocked ears such as Eustachian Tube Dysfunction and Otitis Externa. Quite often patients come to their doctor asking for removal of ear wax, but it turns out that there is no wax build-up and the symptoms are caused by something else.
• Over-the-counter wax-dissolving ear drops are helpful- they soften the wax and may help it to come out. However, they should not be used if you have a perforated eardrum.
• Research suggests lukewarm water or olive oil may be just as effective as ear-drops, as they gently melt the wax.

• Your GP or Ear Nose & Throat Specialist can perform removal of ear wax by syringing warm water into the ear, or by microsuction (like a miniature vacuum cleaner). Occasionally other techniques or tools such as forceps may be used. You may be advised to soften the wax before these treatments, by using ear drops.
• Ear candles are not advisable, due to the risk of burns and damage to the eardrum.

How can you stop ear wax building up?

• Avoid cleaning the inside of your ears with fingernails or cotton buds etc- just clean the ear wax gently when it naturally comes to the opening of the ear canal
• If you have a skin condition such as eczema in the ear area, get this treated
• If you’re prone to wax build-up, it may help to use ear-drops to soften the wax every week or so. Speak to your pharmacist about products that may help.

Further patient resources

www.betterhealth.vic.gov.au

Article references

BMJ Clinical Evidence

www.racgp.com.au

www.cochrane.org

What is the treatment for Swimmer’s Ear?

Treatment of Swimmer’s Ear may involve:

• antibiotic and/or steroid ear drops (sometimes the doctor may recommend inserting a “wick” which has been soaked in the medicated drops)
• antibiotic tablets
• pain relief
• sometimes the canal may need to be cleaned out by a doctor
• getting proper treatment for underlying conditions such as eczema and diabetes

How long does it take treatment for Swimmer’s Ear to work?

• It usually takes a week or so for ear drops to completely clear the symptoms of Swimmer’s Ear.
• Treatment is often prescribed for 7 to 10 days, but your doctor may advise a longer course depending on your symptoms.
• It’s often recommended to continue ear drops for a couple of days after the symptoms have disappeared.

How can you avoid Swimmer’s Ear?

• dry ears gently but carefully after swimming or bathing
• avoid putting things such as cotton buds (or your fingers!) inside your ears
• avoid swimming or bathing in dirty water
• avoid irritating hair products (or wear ear plugs while applying)
• consider wearing a swimming cap or ear plugs while swimming

What are the complications of Swimmer’s Ear?

Complications of Swimmer’s Ear can include:

• Chronic Otitis Externa – in some people the symptoms keep coming back after treatment and can become almost constant in some cases. In people who get repeated infection, the ear canal may become narrowed over time, further contributing to the problem.
• Cellulitis- infection can spread to the tissue around the ear, and into the face, leading to increased pain, fevers, redness and swelling. Cellulitis is a serious condition and requires immediate medical attention, as an antibiotic drip may be needed.
• Malignant Otitis Externa is when infection spreads to bones and cartilage around the ear, and potentially further into the brain. People with weakened immune systems are more at risk. It is a very serious condition and requires emergency medical treatment such as intravenous antibiotics and occasionally surgery. Anyone with Swimmer’s Ear who experiences worsening fevers, muscle weakness in the face, dizziness, headaches or general unwellness, should see a doctor immediately.

If you have concerns about Otitis Externa (Swimmer’s Ear), speak to your GP or an Ear Nose & Throat Specialist.

Patient Resources

www.betterhealth.vic.gov.au

Article Resources

www.cochrane.org

www.aafp.org

Otitis Media (middle ear infection)

Acute Otitis Media is an infection of the middle ear. The middle ear is the chamber behind the eardrum. Otitis Media can be caused by bacteria or viruses. It is very common in small children. If children get repeated bouts of Otitis Media leading to reduced hearing, sometimes it’s advised they have grommets (ventilation tubes) inserted.

Symptoms of Acute Otitis Media include earache, fever, a feeling of blocked ears and reduced hearing. Smaller children may pull at their ears, seem irritable, lethargic and/or stop eating and drinking as well as usual. Vomiting may also occur.  Treatment with antibiotics may be required.

Foreign Body

Now and then a blocked ear may be due to a foreign body, for example, the tip of a cotton bud or dirt particles that enter the ear while working in a dusty environment. Sometimes small children may put small objects in their ears- the first symptom may be an unpleasant odour or discharge coming from the affected ear.

If one or both of your ears feel blocked, you should see your doctor for assessment. Whilst the cause of blocked ears is often one of the common issues explained above, sometimes there can be rarer or more serious causes, which may require further investigation such as hearing tests and scans.

Further patient information

www.healthdirect.gov.au

Article resources

www.cochrane.org

Who gets Eustachian Tube Dysfunction?

• Anyone can get it, but it’s more common in kids, as their tubes are smaller and narrower. Children also naturally get more viral illnesses, as their immune systems are still maturing.
• People who fly a lot may also be prone to it.
• And as mentioned above, smoking and obesity may increase symptoms.

What is the best treatment for Eustachian Tube Dysfunction?

In many cases, symptoms of Eustachian Tube Dysfunction get better after a few days, without any treatment.

Depending on the cause, things that may help include:

• Using a decongestant spray if you have a head cold ( to reduce mucus and postnasal drip)
• Using an antihistamine and/or steroid nasal spray if you get hay fever (you may need to use these long term, depending on whether your hay fever is seasonal or year-round)
• Chewing gum, drinking water, and purposely “popping” your ears may encourage the Eustachian Tubes to open, offering some relief.
• Blowing up balloons may help!
• Stop smoking
• If you’re overweight, losing weight may help