Dangers of Microsuction to Remove Ear Wax — Awareness and Reporting

[Gman]

There's a worrying number of cases where microsuction has caused or worsened tinnitus and hyperacusis. It's happened to me.

There is compelling research that this procedure is dangerous. It doesn't help that ENTs are naively vacuuming people's ears as though it is perfectly safe and providing no warnings about potential life-changing adverse effects.

• Suction-generated Noise in an Anatomic Silicon Ear Model
• Suction-generated Noise Levels During Aural Toilet
• Microsuction Aural Toilet in ENT Outpatients: A Questionnaire to Evaluate the Patient Experience

There is an FDA online reporting tool that allows people to report adverse events from medicines and medical devices:

• FDA MedWatch

I'm not in the US, so not sure if it is just for Americans. Other countries may have similar reporting methods.

 

[ibeca]

The suction sound is pretty loud while they do it, and my tinnitus is spiking like crazy right now. Had microsuction yesterday at the hospital.
I wish I saw this post earlier.

 

[Enkidu]

First of all, hello all, long-time lurker and first time poster on Tinnitus Talk.

My tinnitus worsened after a microsuction procedure at Specsavers and I developed hyperacusis and TTTS, both of which I didn't have before. Before I booked my appointment I remember checking some of the posts on here about it, including many of yours @Gman.

I outlined my many concerns to the audiologist before the procedure (I had a bad experience with syringing before) and was alarmed by a contract I had to sign that stated that this could temporarily/permanently worsen tinnitus. I remember expressing my worries to her, saying something along the lines of "well if the choice is between irrigation and microsuction and they both have risks, what other choice do I have?" She basically said there was no other choice. Later I found out Specsavers offered manual wax removal. I hardly had any wax (the audiologist actually commented on how little there was in there) and there is only one reason I can think of as to why she didn't offer me a manual removal - pure ignorance.

I'm trying not to feel too resentful although the "what ifs" plague me every day. The key thing is that audiologists and ENTs step up to the fact that a significant amount of tinnitus sufferers react adversely to this procedure. I am willing to work with other people who have suffered needlessly due to this to get these professionals to own up to the dangers and make proper assessments of patients whose hearing is in their hands. How can so many of us be wrong?

 

[judith ingley]

my tinnitus is horrible now after the ear-wax suction 6 months ago--the ent doctors of all people really should be more informed about this procedure--life changing for me

 

[GBB]

my tinnitus is horrible now after the ear-wax suction 6 months ago--the ent doctors of all people really should be more informed about this procedure--life changing for me

Mine also went from "cured" to an extremely debilitating level following microsuction. I wish I had exercised more caution.

 

[dan]

and was alarmed by a contract I had to sign that stated that this could temporarily/permanently worsen tinnitus.

ENT: Dan, by signing this contract you're aware of me possibly worsening your tinnitus.
Dan: Up Yours doc!

 

[Gman]

First of all, hello all, long-time lurker and first time poster on Tinnitus Talk.

My tinnitus worsened after a microsuction procedure at Specsavers and I developed hyperacusis and TTTS, both of which I didn't have before. Before I booked my appointment I remember checking some of the posts on here about it, including many of yours @Gman.

I outlined my many concerns to the audiologist before the procedure (I had a bad experience with syringing before) and was alarmed by a contract I had to sign that stated that this could temporarily/permanently worsen tinnitus. I remember expressing my worries to her, saying something along the lines of "well if the choice is between irrigation and microsuction and they both have risks, what other choice do I have?" She basically said there was no other choice. Later I found out Specsavers offered manual wax removal. I hardly had any wax (the audiologist actually commented on how little there was in there) and there is only one reason I can think of as to why she didn't offer me a manual removal - pure ignorance.

I'm trying not to feel too resentful although the "what ifs" plague me every day. The key thing is that audiologists and ENTs step up to the fact that a significant amount of tinnitus sufferers react adversely to this procedure. I am willing to work with other people who have suffered needlessly due to this to get these professionals to own up to the dangers and make proper assessments of patients whose hearing is in their hands. How can so many of us be wrong?

I'm really sorry that happened to you. It's just utter medical negligence on their part. There's just too many of these criminals around. Never imagined specsavers would offer microsuction. They're bad enough when it comes to vision related things.

I would only ever get ear wax manually removed by a reputable ENT now and only with reluctance and an abundance of caution. So far, I haven't had to.

After life altering/ruining events, we have to maintain a certain level of distrust and vigilance to guard against future incidences. It's pretty sad but necessary.

 

[Michael Leigh]

Whenever microsuction is mentioned in this forum and others I attend it causes much debate. Some people experience no problems others say it made their tinnitus worse and regret having it. Something I fully understand, living with variable tinnitus that can reach severe levels. I have had microsuction three times at ENT and ear syringing the same at my GP practice and fortunately had no problems.

Some people believe the safest method of earwax removal is manual using a curette. However, problems can still result if the healthcare professional doesn't apply due diligence and care. I have corresponded with people at forums by email and telephone who have noticed their tinnitus increase with all three procedures.
One of the main causes of problems is that people weren't told to apply eardrops/olive oil 3x a day to each ear for 7 to 10 days prior to having the wax removed. This should soften the wax sufficiently allowing easy removal using microsuction, syringing or by curette.

Another cause is that the person carrying out the work, might not apply the due diligence and care I speak of – he or she may be strapped for time, perhaps appointments are backing up or just having a bad day. This shouldn't happen but it can from what people have told me. The person was rough and in a hurry I've been told. With every medical procedure there is an element of risk. Although earwax removal may seem relatively minor, if a problem occurs and the tinnitus increases it becomes very serious indeed.

Michael

 

[Ken219]

With every medical procedure there is an element of risk.

Not to the doctor!

 

[Enkidu]

Whenever microsuction is mentioned in this forum and others I attend it causes much debate. Some people experience no problems others say it made their tinnitus worse and regret having it. Something I fully understand, living with variable tinnitus that can reach severe levels. I have had microsuction three times at ENT and ear syringing the same at my GP practice and fortunately had no problems.

Some people believe the safest method of earwax removal is manual using a curette. However, problems can still result if the healthcare professional doesn't apply due diligence and care. I have corresponded with people at forums by email and telephone who have noticed their tinnitus increase with all three procedures.
One of the main causes of problems is that people weren't told to apply eardrops/olive oil 3x a day to each ear for 7 to 10 days prior to having the wax removed. This should soften the wax sufficiently allowing easy removal using microsuction, syringing or by curette.

Another cause is that the person carrying out the work, might not apply the due diligence and care I speak of – he or she may be strapped for time, perhaps appointments are backing up or just having a bad day. This shouldn't happen but it can from what people have told me. The person was rough and in a hurry I've been told. With every medical procedure there is an element of risk. Although earwax removal may seem relatively minor, if a problem occurs and the tinnitus increases it becomes very serious indeed.

Michael

I used olive oil drops every day for 2 weeks prior. That's not the problem here.

For someone who is constantly warning of the dangers of headphone usage, surely you must be able to see that a noisy suction machine inserted right into the ear canal may be a bigger risk to noise induced tinnitus sufferers than a practically silent manual removal?

 

[Michael Leigh]

I used olive oil drops every day for 2 weeks prior. That's not the problem here.

For someone who is constantly warning of the dangers of headphone usage, surely you must be able to see that a noisy suction machine inserted right into the ear canal may be a bigger risk to noise induced tinnitus sufferers than a practically silent manual removal?

Since you want to be pedantic please note the following: Your tinnitus was caused by scuba diving as mentioned on your Avatar and not "noise induced tinnitus". Therefore you know nothing about this condition. I agree that microsuction emits a loud sound but this is not always the cause of increased tinnitus when someone has microsuction. The usual reason for problems is that the patient hasn't been advised of the correct procedure before wax is removed. This is to administer eardrops 3x a day to each ear for 7 to 10 days to soften the wax thoroughly and enable easy removal with less risk.

I have corresponded with various people that have had problems with microsuction and ear irrigation and not all of them have noise induced tinnitus. Some never experienced tinnitus before others have tinnitus caused by an underlying medical problem. Many were told the use of eardrops is not required when having microscution, others have been told only use eardrops for a day or two which is wrong. It is unfortunate that you had problems with microsuction at Specsavers - I would never allow them near my ears but you weren't to know. It should always be done by a doctor at a hospital ENT clinic as I have done on three occasions. I believe they are more skilled and adept in dealing with matters concerning the ears. The ear is a very delicate organ and many people do not realize this until something goes wrong with it.

People that develop tinnitus from headphone use including myself, is the result of using them at too high a volume and for long durations sometimes years. The tinnitus is not noticed at first because the brain can easily ignore it until one day it makes its presence known. This is completely different from the noise of microsuction. A person with acute hyperacusis, I would not recommend that they have microsuction - not that it will necessarily make the condition worse, but because of psychological impact that noise will make it worse. If the wax is impacted and syringing and manual removal is unsuccessful, then microsuction needs to be performed otherwise, the impacted earwax will cause a host of problems including causing tinnitus or make existing tinnitus worse.

Michael

 

[Ken219]

@Michael Leigh how would you like to be the 1 in a million that microsuction exacerbates your condition?

 

[Michael Leigh]

@Michael Leigh how would you like to be the 1 in a million that microsuction exacerbates your condition?

I have already mentioned the removal of earwax is a medical procedure. Although it may be considered minor there is an element of risk. Not been told to carry out the proper procedure before wax removal and not carried out by a skilled medical professional preferably an ENT doctor. These are often the cause of problems with microsuction based on the many people I have corresponded with.

Saying that I appreciate problems can still occur for as I've said there is an element of risk, whether it's microsuction, ear irrigation or manual removal using a curette.

 

[Enkidu]

Since you want to be pedantic please note the following: Your tinnitus was caused by scuba diving as mentioned on your Avatar and not "noise induced tinnitus" . Therefore you know nothing about this condition. I agree that microsuction emits a loud sound but this is not always the cause of increased tinnitus when someone has microsuction. The usual reason for problems is that the patient hasn't been advised of the correct procedure before wax is removed. This is to administer eardrops 3x a day to each ear for 7 to 10 days to soften the wax thoroughly and enable easy removal with less risk.

I have corresponded with various people that have had problems with microsuction and ear irrigation and not all of them have noise induced tinnitus. Some never experienced tinnitus before others have tinnitus caused by an underlying medical problem. Many were told the use of eardrops is not required when having microscution, others have been told only use eardrops for a day or two which is wrong. It is unfortunate that you had problems with microsuction at Specsavers - I would never allow them near my ears but you weren't to know. It should always be done by a doctor at a hospital ENT clinic as I have done on three occasions.

People that develop tinnitus from headphone use including myself, is the result of using them at too high a volume and for long durations sometimes years. The tinnitus is not noticed at first because the brain can easily ignore it until one day it makes its presence known. This is completely different from noise from a microsuction. A person with acute hyperacusis, I would not recommend that they have microsuction - not that it will necessarily make the condition worse, but because of psychological impact that noise will make it worse. If the wax is impacted and syringing and manual removal is unsuccessful, then microsuction needs to be performed otherwise, the impacted earwax will cause a host of problems including making tinnitus worse.

Michael

Apologies if you found it pedantic, I would say it's equally condescending to state I know nothing about the condition. Granted, I can only talk from my own experience over the past year and a half. Alhough my initial ear injury was due to equalising issues during scuba diving, I have had spikes from noise since then, including a major one from syringing on the NHS (not a quiet method either) and another one from the supposedly safer microsuction. That suggests strongly to me that both these procedures should be used with extreme caution among people like myself and only in the event of assessing that it would be too risky to remove manually due to impaction or sheer volume of wax.

 

[Michael Leigh]

Apologies if you found it pedantic, I would say it's equally condescending to state I know nothing about the condition. Granted, I can only talk from my own experience over the past year and a half. Alhough my initial ear injury was due to equalising issues during scuba diving, I have had spikes from noise since then, including a major one from syringing on the NHS (not a quiet method either) and another one from the supposedly safer microsuction. That suggests strongly to me that both these procedures should be used with extreme caution among people like myself and only in the event of assessing that it would be too risky to remove manually due to impaction or sheer volume of wax.

You were showing disrespect and have now redeemed yourself. I am sorry to hear of your discomfort and hope things improve for you in the future.

I wish you well.
Michael

 

[Ken219]

I have already mentioned the removal of earwax is a medical procedure. Although it may be considered minor there is an element of risk. Not been told to carry out the proper procedure before wax removal and not carried out by a skilled medical professional preferably an ENT doctor. These are often the cause of problems with microsuction based on the many people I have corresponded with.

Saying that I appreciate problems can still occur for as I've said there is an element of risk, whether it's microsuction, ear irrigation or manual removal using a curette.

Michael, I have to say you are one smart person. I do respect and admire your contribution to this website. At times I am in awe of your knowledge. I'm a long time sufferer and didn't hear of tinnitus until I got it. Back in the day there was no internet and when my tinnitus was severe I went to the library to research it. I remember there were three books on the subject. All doom and gloom. It was a very lonely time. I found the ATA and read with hope. But 30 years later ATA has the same recommendations and articles. Michael, I thank you from my heart for your contributions. Keep them coming.

G-d bless.

Ken

 

[Michael Leigh]

Michael, I have to say you are one smart person. I do respect and admire your contribution to this website. At times I am in awe of your knowledge. I'm a long time sufferer and didn't hear of tinnitus until I got it. Back in the day there was no internet and when my tinnitus was severe I went to the library to research it. I remember there were three books on the subject. All doom and gloom. It was a very lonely time. I found the ATA and read with hope. But 30 years later ATA has the same recommendations and articles. Michael, I thank you from my heart for your contributions. Keep them coming.

G-d bless.

Ken

@Ken219

HI Ken,

Thank you for your kind words I am deeply humbled by them. Like you I've had noise induced tinnitus for many years. The experiences you speak of about the ATA I found to be similar at the BTA. To be fair, I once found the organization's Journal QUIET, helpful and informative and acquired a lot of knowledge from fellow tinnitus sufferers via its letter pages. This was long before the Internet where people corresponded using snail mail. They also had a Tinnitus Support contacts page. Here, people experienced with tinnitus submitted their telephone number. Anyone wishing to contact them for help with tinnitus could do so and it was entirely voluntary.

I used the service a number of times when I was having difficulty with tinnitus in the early stages. Years later I become a tinnitus support contact. Having left the BTA I still continued to correspond with people by telephone, here in the UK and abroad with anyone wanting help with noise induced tinnitus and hyperacusis. I also correspond with people at forums and email. It is my way of giving something back as I was once helped.

Like you I acquired knowledge from tinnitus books and done a lot of research back in the day. I have learnt a lot from people at tinnitus forums. Tinnitus is complex condition so no-one knows it all and there's always something new to learn. Although tinnitus can be caused by many things, it's noise induced tinnitus that I try not to steer too far away from, because that's what I'm familiar with and also hyperacusis, when it's brought on by exposure to loud noise.

Take care and all the best
Michael

 

[Mr_Orange_3737]

I got tinnitus and hyperacusis from syringing about 2.5 months ago. The nurse said that it's not ideal, but you can do the syringing without eardrops. I'm someone that has hard earwax. My tinnitus started 5 hours later that night.

I've tried to read many posts here on this subject.

There's so much mention of the important of eardrops to loosen up the wax. However, what exactly happens when you don't? What is the damage that's being done? I've been having a hard time trying to find the right classification for this type of trauma to the ear.

If the word on using drops to loosen up wax seems to have been out there for a while, someone must've stumbled across a good reason for it.

I've spoken to 3 ENTs and they all say that syringing even without Debrox is fine.

 

[Contrast]

We have a HUGE body of evidence on this forum of people getting harmed from Microsuction but Academia™ is slow to catch up. They still pretend it's extremely rare when we know it's not. You know what they say it takes like a decade before new medical phenomena are acknowledged.

It's like sticking a vacuum cleaner in your ear and sucking out all the hair cells.

 

[Static Sophie 73]

I only ever get a manual clean for ear wax. Never will I have the microsuction procedure - I had it once and never again.

 

[RonnieThailand]

Mine was caused recently by an ENT doctor in a hospital in Thailand.

Microsuction/irrigation, woke up at 4 am the next day with loud ringing in one ear which went to two ears within a week.

5 weeks in and it has completely destroyed my life. I have hyperacusis and can't tolerate water from the faucet. Severe pain in my ears and constant sounds that are torturing. I can't work a job like this. I can't watch TV, or listen to music, or have conversations with people. I can't be around other people or sounds.

I hate the FDA for allowing this procedure to continue, whether in the USA or other countries.

 

[Blue28]

I have not been on the forum for a while and came back recently. I've just seen this thread today and felt compelled to add my experience as I'm deeply aggrieved by the whole microsuction experience.

In 2016 I saw an ENT as I had a wax build up in one ear. Long story short he suctioned BOTH ears, the procedure was extremely loud and caused some pain. I immediately felt a fullness in my ears but thought nothing of it as I wasn't aware that microsuction was dangerous. In the following days I developed screaming tinnitus, painful hyperacusis and tonic tensor tympani syndrome. I couldn't stand any kind of noise, and being a new mum meant I had to wear ear muffs just to care for my baby.

I complained to the ENT who denied that microsuction could cause damage to hearing and stated that I must have had tinnitus before. I was disgusted. When I made a formal complaint, he claimed that I was psychologically unstable! The lengths that this doctor went to to shift the blame onto me was astonishing and sickening. Needless to say, nothing came of my complaint.

5 years on and I still have debilitating tinnitus, daily headaches, hyperacusis, ear fullness and following my initial hearing loss, my hearing has continued to deteriorate (I suspect that I have cochlear hydrops caused by the deterioration of my inner ears from the loud microsuction).

I'm so angry to read that 5 years after my life changing experience from microsuction, this procedure is still being practiced with such naivety by ENTs and audiologists. How can we change this? What can we collectively do to make a difference?

Please feel free to read my full post here:

The Dangers of Microsuction

 

[Rali]

I had microsuction only it the right ear, but now I suffer terribly in both ears from pain, hyperacusis, ear fullness, popping, itching, tinnitus,....It started to hurt at the night after rhe procedure and i thought it is only a reaction of the ears. Then it settled down for some days and now ( 42days after) I would go crazy. I have called the doctor who did it and he asked me why didn't I call earlier and that it couldn't affect the untreated ear, so it is improssible to be result of the microsuction. But I didn't have any issues with ears before that. I don't know what to do...My famuly can't understand what is going on. I am in deep despair and panic that it will never go away and I will have to live with it.

 

[Wrfortiscue]

I had microsuction only it the right ear, but now I suffer terribly in both ears from pain, hyperacusis, ear fullness, popping, itching, tinnitus,....It started to hurt at the night after rhe procedure and i thought it is only a reaction of the ears. Then it settled down for some days and now ( 42days after) I would go crazy. I have called the doctor who did it and he asked me why didn't I call earlier and that it couldn't affect the untreated ear, so it is improssible to be result of the microsuction. But I didn't have any issues with ears before that. I don't know what to do...My famuly can't understand what is going on. I am in deep despair and panic that it will never go away and I will have to live with it.

It's crazy how the medical world is so behind on ear treatment.