Ear Wax

Leicestershire Policy for Ear Wax Removal: Wax is an important and natural secretion found in the ear. It keeps the ear canal lubricated and protects the ear against dust, dirt and bacteria, which helps to prevent infection. LLR CCGs will only fund secondary care treatment where one of the following criteria is met

• The person has (or is suspected to have) a chronic perforation of the tympanic membrane or healed perforation
• There is a past history of ear surgery
• There is a foreign body with ear wax (including vegetable matter) in the ear canal
• The patient is suffering from significant symptoms due to ear wax build up including hearing loss or pain and the patients’ condition warrants micro suction
• Has a recent history of Otalgia and/ or middle ear infection (in the past 6 week)
• Has had previous complications following ear irrigation including perforation of the ear drum, severe pain, deafness or vertigo
• Two attempts at irrigation of the ear canal in primary care are unsuccessful
• Removal of ear wax in patients who have already had ear irrigation in primary care and need complete removal of any residual wax prior to hearing aid fit
• Ear canal stenosis
• Active skin condition of ear, eczema, psoriasis
• Recent head injury
• Wax in only hearing ear (do not irrigate)
• If ear wax is totally occluding the ear canal and any of the following are present
• Hearing loss with any of the following
• Earache
• Tinnitus
• Vertigo
• Cough suspected to be due to ear wax
• Tympanic membrane is obscured by wax but needs to be viewed to establish a diagnosis
• If the person wears a hearing aid, wax is present and an impression needs to be taken of the ear canal for a mould, or if wax is causing the hearing aid to whistle

Guidance www.nice.org.uk/news/article/