Download Microsuction Patient Leaflet - Cambridgeshire and Peterborough CCG

Management of Impacted Ear Wax
Patient diagnosed with
impacted ear wax – no
complications
If drops successful no
further intervention
required
Advise patient to use olive oil
drops (over the counter) for two
weeks
If problem persists attempt ear
irrigation in surgery unless
contraindications (see below)
If first attempt at ear irrigation
is unsuccessful repeat
procedure unless patient is
unable to tolerate procedure or
complications developed
If ear irrigation
successful, no further
intervention required
If drops and irrigation fail to
resolve problem, refer patient
for Microsuction at Sawston**
Contraindications to ear irrigation
• The patient has previously experienced significant complications following ear irrigation in the
past e.g. perforation, severe vertigo.
• There is a diagnosis of middle ear infection in the past 6 weeks
• The patient has undergone any form of ear surgery (this excludes grommets that have extruded
at least 18 months ago and the patient has been discharged from Ear, Nose and Throat services)
• The patient has current perforation (it is acceptable to irrigate the non-affected ear if there are no
abnormalities).
• The patient has a cleft palate (whether repaired or not)
•
The patient has acute otitis externa with pain and tenderness around the pinna
• Patient is currently taking warfarin therapy and their most recent INR is above their target range
V1 May 2015
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•
•
•
Acute undiagnosed hearing loss that is not related to the accumulation of ear wax
The patient has had mastoid surgery
The patient is unable to cooperate or tolerate the procedure
Presence of non-hygroscopic matter such as peas, lentils, cotton ear buds
Ear irrigation should be used with caution in patients with:
• Tinnitus
• Healed perforation
•
Dizziness
**NB. Patients requiring microsuction, after the steps above have been followed should be
referred to the Sawston Microsuction Service, with the exception of the following
exclusions:•
•
•
•
•
•
•
•
•
•
Patients aged 15 and under
Patients requiring treatment other than microsuction
Differentiated undiagnosed ear conditions
Nose & throat conditions requiring rapid Access
Removal of superglue in the ear
Sudden unilateral hearing loss with tinnitus
Undifferentiated Diagnosis of Vertigo/Dizzy Patient
Malignant Otitis Externa (Diabetic Patients with Bony Erosion)
Sudden Unilateral Otitis media with effusion in an Adult
Acute episode of external and middle ear infections that can be initially treated
using first line course of treatment
V1 May 2015