Queensland Otology offers a rapid-access ear toileting service. We provide prompt service as blockage of the ear with debris or other matter can be distressing due to pain or discomfort, which can impede one’s ability to work and/or conduct other activities, and unattended cases can lead to further problems.

Whilst many cases respond well to traditional syringing techniques, other sophisticated equipment can be used that are often unavailable in either the family practice or ER environments (operating microscopes, micro-instrumentation, suction and lighting).

Several situations present commonly:

• Impacted hard wax may prove difficult to remove if lodged deeply, requiring fine instrumentation to dislodge the mass.
• Masses or sheets of dead skin are often adherent to the canal wall and resist syringing. This necessitates removal by either suction or with micro-forceps. Hard masses of dead skin are found in cases of keratosis obturans. Particular cleaning skills are needed for these cases.
• Narrow or curved external canals, or those with exostoses (bony lumps associated with water sports) are difficult to access even under microscopy.
• Oily ear drops or common remedies (olive oil, commercial ear preparations) block the ear by forming a meniscus against the drum that is slow to evaporate and difficult to clear by simple means.
• Wax or dead skin may form a film on the eardrum itself. This may be difficult to visualise and remove, necessitating the use of an operating microscope and appropriate micro-instrumentation.
• Self-inflicted problems are not uncommon. Cotton-buds/Q-tips are generally too wide to clean ears. They frequently cause impaction of firm wax deep in the canal. Likewise, hearing aid moulds may obstruct the canal.
• Similarly, foreign bodies in the ears are common, particularly in children, and are often impacted deep in the external canal against the eardrum. This often renders their removal difficult, painful, or dangerous, requiring specialised instrumentation and expertise.
• Infection is a common problem.
  • External bacterial infections may cause canal oedema and pain, rendering cleaning a distressing experience.
  • Fungal infections often persist for weeks unless cleared by expert microsuction.
  • The mucoid discharge of a perforated drum will continue to perpetuate problems unless cleared efficiently.
  • Chronic myringitis is very difficult to treat even with expert care.
  • Cholesteatoma causing foul or bloodstained discharge, may go unnoticed unless scrutinised microscopically.

• Lastly, expert cleaning may be necessary for treatment-related problems. Drum perforations, canal trauma and infection are not infrequent after syringing. Perforations commonly occur in previously-weakened drums, and canal trauma from either unsteady hands or jerking patient movement. Fortunately, these mishaps normally resolve with conservative care.
• Mastoid cavities, as a result of radical treatment of cholesteatoma, are a particular problem and are outlined in detail elsewhere on this site. Expert cleaning is mandatory for these cases and problems may persist despite best care.