What are the risks of seeking help from an unqualified clinician for earwax microsuction

She paid £30 to clean the earwax in her right ear in a Pharmacy in SE London. It was such a relief, especially since she paid half price. HearingNow charges £65 to clean both sides. So it was a win; she saved £35.

She came to my clinic complaining about severe irritation, a constant hissing, and moderate pain in the right ear and some pain in the right side of her head. She explained that a month and a half ago, she visited a local pharmacy and had the earwax cleaned in the same ear, but it keeps coming back!

Otoscopy of the right ear canal of the patient - a fungal infection

What was blocking her right ear canal was not earwax; it was a severe fungal infection. The skin in the ear canal was severely irritated, and the clouds of infection were semi-hard and sticky, indicating that the ear infection must have started some 3-4 months ago. The patient was a regular member of the swimming pool at Forest Hill Pools.

I attended to the patient, and the infection in the ear canal was sorted out through the medication that she received from her GP. This incident signalled to me to write this brief.

Here are the risks of leaving your hearing care to unqualified clinicians:

• Diagnosis - An infection in the outer ear is not a major health threat, but an unattended earwax infection can cause other more serious problems. That's why, like other health problems, early and proper diagnosis of an ear infection is important. You have a better chance of having an outer ear infection noticed by an audiologist than by a clinician in a local pharmacy.

• Thorough procedure - Depending on the depth of an outer ear infection and the stage of it, the cleaning procedure may be different. An unattended outer ear infection could be extended deep to the eardrum. Observing the condition of the eardrum is also critical in how the procedure is done. Again, you want an experienced audiologist to handle the cleaning and microsuction procedure rather than a junior technician. That is often why clinics charge more for ear infection cleaning compared to a regular earwax microsuction.

• A referral to GP - An experienced audiologist can clean your infected outer ear and refer you to your GP or even to the closest A&E department.

• Free follow-up - In HearingNow, we offer a free follow-up for patients who go through the ear infection cleaning procedure. This is a critical stage, as after the initial cleaning the patient and applying the medication you receive from the GP, you need to make sure that the infection is thoroughly managed. Sometimes the ear infection can come back in a few weeks. This could be due to a few scenarios, including a. the medication received was not quite fit for the type of fungi or bacteria, and/or b. the patient introduced the infection back to his/her ear canal again. The latter can happen by putting your finger in your ear canal to scratch it, or so. You need to understand that some of these bacteria are quite resilient. A follow-up of about 3-4 weeks after applying the medication for an ear infection would warrant that the treatment has been successful.

• Instructions - What to do and what not to do - In tandem with the point above, an audiologist can help you adher instruction so you and people around you are in a better position against the ear infection, so hopefully it is completely treated, and also it is not passed on to anyone around you in your household. Examples of such instructions are whether you can go to the swimming pool or not, or how to make sure that the fungi is thoroughly cleaned out in your house.

  
  

Conclusion

A sense of itchy ear, mild pain (or discomfort), tinnitus in one ear or side of the head could be due to an ear infection. For a better diagnosis, cleaning and aftercare, I would strongly suggest visiting a local clinic rather than a pharmacy for earwax or infection removal by microsuction.