Ear Plugs, Microsuction, and Bad Advice.

[Tom Riordan]

I woke up one morning with a completely wax clogged right ear. This had happened before, so I was not too panicked--previously in my life I had flushed it out at general practitioners' offices with no harm or damage. I am a DJ and audio engineer, so I frequently wore ear plugs and was aware of the dangers of loud environments.

The ENT I decided to go to proceeded to use micro-suction to remove the wax. This experience was 1. Painful and 2. LOUD. I was sitting in the chair nervous, with the feeling that "The Dr. knows what they are doing, but I shouldn't be feeling this...I feel like my ear is going to pop"

After the wax was removed, something wasn't right. I am an audio engineer and can pick apart frequency bands well, without hearing tests -- I knew that the "wind noise" above 10k had disappeared in that ear completely. They proceeded to test my hearing, telling me everything was "perfectly fine"... but it clearly was not. I could hear upper frequency sine waves they were playing, but the higher frequency bands that give vocals and wind noises breathiness and air had disappeared.

Additionally, in the vocal range from about 1k-4k I now experience ultra sensitivity in my right ear--somewhat of a narrow band "notch filter" effect that some other audio engineers might be familiar with when EQing sources. It sounds like distortion. The higher frequencies above 10k are gone completely.

Since then, I've found vigorous exercise and avoiding salt helps-- sometimes the tinnitus subsiding completely. I've also found that ironically store bought ear plugs make my ears ring terribly the next day, and on the nights where I leave the plugs out my ears feel OK the next day.

This counter-intuitive experience has led me to believe that earplugs can create a resonant cavity in the ear canal, which hyper-amplifies certain frequencies, which end up vibrating the entire ear structure sympathetically. (IE open tube vs. closed tube resonance)

Another counter-intuitive experience I have had is that loud, subsonic frequencies played over headphones cause the ringing to subside for a while--my theory is that the low frequencies vibrate the liquid in the cochlea, giving temporary rise to certain cilia that are otherwise flattened and dead--like giving the cochlea a deep massage. This is speculative, but my experience has shown this many times.

Fast forward two years-today I went to an ENT for the same problem I went to last time. but this in the left ear this time. I explained my experience that the last ENT had most likely given me tinnitus, but I didn't speak up when he brought out the micro-suction tube. I screamed in pain as he sucked the wax from my inner ear canal, which I was scolded for "Alarming the other patients". I was told to calm down, and I was told the canal was clean, while repeatedly mentioning that it felt like my ear was still blocked. I broke down in the office and began panicking. I put my face in my hands.

Now I am sitting here hours later, and while I do not have ringing in my left ear it sounds like I am holding up a sea-shell to my ear, and it is filled with cotton. When I close the ear, a brief white noise can be heard and then re-adjusts to a silent baseline (a good sign hopefully). When my ear is opened, the shell noise persists --it also seems that certain frequency bands are being attenuated in the upper mid-range, and the highest white noise "ocean" sounding frequencies are being amplified from my inner ear to compensate. When I open the ear up again, it sounds normal, but slowly the inner ear adjusts and begins pumping high frequencies again--once again the feeling of a blockage persists.

Moral of the story-- and I hope for any ENT professionals reading this-- micro-suction is DANGEROUSLY over-promoted as the safest method for ear cleaning. It seems to me that quite the opposite is true when it comes to serious wax blockages. The devices used are far to brutish -- the suction is too powerful and the opening too large-- in relation to the tympanic membrane the suction tube seems too big. The vacuum created by a total blockage can further amplify the transmission of high pressure into the ear when the blockage is penetrated (CRACKLE POP!)

I am trying not to be distraught until a few days to see if this clears up, but I am very worried. To the ENT's reading this, please use smaller suction tubes with adjustable suction (if it exists), or not at all. I now sit here with a ringing in my right ear and sea-shell on my left-- I'd rather have both ears clogged shut for life if this persists.

My final thought for medical professionals -- listen to your patients. Still very little is known about the ear, and you should recognize that and take our input and anecdotal experience very seriously, and continue to take those stories and share them to those who are engaged in research. I feel I have been steamrolled by the ENT's I've come in contact with -- let us not forget the medical device sales people who most likely promoted micro suction in the first place. Praying this subsides.

 

[Bill Bauer]

I am so sorry that you had to live through this.

In the future, you will want to use the special drops for 7-14 days prior to your wax cleaning appointment to soften the wax, and then you can ask the doctor to use manual tools.

Likewise, if you go for dental cleaning, make sure to insist on manual cleaning, and turn down their sonic implements.

 

[Michael Leigh]

I have had microsuction 3 times and ear irrigation the same and haven't had any problems and my tinnitus is quite severe. There is no doubt it is noisy and can be uncomfortable even slightly painful procedure at times. However, it is considered the best method of removing earwax particularly when it is impacted and irrigation won't work and manual removal using a curette could make matters worse.

I asked my ENT consultant who's an Audiovestibular physician and performed microsuction on me to remove earwax twice, which is the best and safest method of wax removal for people with tinnitus. Without a second thought she said microsuction. As I have mentioned before, there is always an element of risk in every medical procedure including earwax removal by: microsuction, irrigation or manual using curette. Therefore, it is imperative to try and keep risks to a minimum whichever method one chooses when having earwax removed. Apply olive oil/eardrops 3 times a day to each ear for 7 to 10 days prior to having wax removed to completely soften it.

Some people with tinnitus, have told me they were not advised to apply eardrops in the manner I've mentioned before having microsuction, which resulted in them having problems. Ranging from the tinnitus spiking then eventually settling down, to people noticing a more permanent increase in the tinnitus which is quite unfortunate. I have also been told, even when eardrops has been applied in the manner I've stated problems have still occurred with microsuction, ear irrigation and manual removal using curette.

I am alarmed when I read advertisements from some walk-in clinics on the Internet, saying they can remove earwax using microsuction and there's no need to use eardrops to soften the wax and this method is completely safe. This is not true as it clearly carries risk. People have contacted me that developed tinnitus after having microsuction and didn't apply any eardrops to soften the wax as they were not advised by the clinic or told it wasn't necessary. It must be said, some clinics do advise using eardrops usually for 3 days before having microsuction. This is not sufficient and according to my ENT consultant applying eardrops for 7 to 10days is the correct amount of time.

I advise anyone that chooses to have microsuction to have it done at a hospital ENT department and not a walk-in clinic that advertises there services on the Internet. Someone I correspond with at another forum had complications with microsuction and his tinnitus is now louder. He was not advised to use eardrops to soften the wax. He wrote a letter to a medical board to complain about microsuction making his tinnitus worse and the medical professional that carried out the procedure. They replied to him saying: There is no medical evidence that microsuction can make tinnitus worse and they consider it one of the best methods of removing earwax.

Unfortunately, these are the type of people that one will be dealing with if, they try and take such an incident to court. It is very difficult to prove negligence or malpractice against anyone in the medical field. I know someone that tried and it cost him thousands of pounds and got him nowhere. Some in the medical field believe we are mere minions of no importance. They have their medical degrees and sit up there in their ivory tower lording it over us all.

Michael

 

[Tom Riordan]

Michael,

Thank you for your reply. The first time I had the procedure there was no period of softening recommended--the physician tried irrigation and used micro suction after that did not work. This was about 3 years ago--apparently the literature has changed on the subject since then. In both cases, the doctors were accredited MD's.

The second time I had the procedure in my other ear the physician said it was "soft enough" in one ear (I had used hydrogen peroxide) and said the second ear was not soft enough, for which he prescribed ear drops. The first ear is now beginning to ring, and sounds like a shell is being held outside. It also sounds muffled.

I have read several accounts of micro suction going wrong , so while the consensus is that it is safest, I think both physicians I attended were a bit too cavalier in their approach. (https://www.ncbi.nlm.nih.gov/pubmed/22218937)

At the end of the day-- It felt like a firework went off in my ear both times, and the procedure left me worse off then I began. There was a published report that suction can create pops up to 150 db at the site of the suction.

Furthermore, it isn't the doctors who are going to report cases of it going wrong-- if something goes wrong and they admit it in any capacity they can be held liable. It may be a case of the success stories going reported, the unfortunate cases get chalked up as hearing loss due to other causes.

I've now experienced on two occasions a buildup of wax, resulting in a dip in frequency response and clarity. The tinnitus occurred ONLY after the micro suction procedure.

I am leaving this information so it is documented-- as mentioned I can't imagine it being actively documented by a physician that they induced tinnitus in their patient. Call it a "positivity" bias that has perhaps influenced overall literature.

In both cases I was not warned of the possible adverse outcomes. I think this should be treated with more sensitivity. Both cases I was given the procedure the day of the first appointment, with no warning.

 

[Michael Leigh]

HI @Tom Riordan

Thank you for the additional information. I am sorry to hear that you are having problems after microsuction and hope things improve with time. I am sure you are aware as I am that no MD is going to admit they caused a patient's tinnitus to become worse after microsuction. Therefore, my advice to everyone whether they have: microsuction, irrigation or manual removal of earwax. Apply eardrops 3 times a day to each ear for 7 to 10 days before having the wax removed.

Take care and all the best
Michael

 

[Bill Bauer]

I have had microsuction 3 times and ear irrigation the same and haven't had any problems

Michael, 1000 positive experiences don't prove that something is safe. One negative experience proves that it is Unsafe. And in this case, it would appear that the negative experiences are a lot more common, for T sufferers anyway.

 

[PortalNaut]

@Tom Riordan I am sorry you've had to experience this trauma with your ears and hearing, and I HOPE it clears up soon for you. While not an audio engineer (though come to think of it I did editing for 7 years), I do get into the vagaries of the frequencies and my hearing since T. My hearing test at an audiologist was the common kind of 200?-8000 Hz. But I suspect my hearing damage is up above, possibly at 14kHz. I did not get a more advanced test, but if you are concerned, there are tests for the high frequencies. My ENT mentioned it as available for cancer paitents, but on TT others have said you just have to call around to various audiologists.

As to low frequency, I am very effected by amplified sound from 40-180Hz and will generally stay out of venues even with ear plugs. Your idea above is intriguing. I will also point out those low frequencies get to us (me) likely by conduction, so those poor cilia will be vibrated for that 'deep massage" that way as well.

Good luck!

 

[Michael Leigh]

Michael, 1000 positive experiences don't prove that something is safe. One negative experience proves that it is Unsafe. And in this case, it would appear that the negative experiences are a lot more common, for T sufferers anyway.

I agree with you entirely @Bill Bauer Please read my post above where I mention some people do have problems with microsuction. No medical procedure is one hundred percent safe there will always be an element of risk. All we can do is try to minimise that risk: whether one chooses microsuction, irrigation or manual removal using curette. To do this I advise people to apply eardrops 3x a day to each ear for 7 to 10 days before having earwax removed. As I've mentioned in my post above. Someone I know at another tinnitus forum wasn't advised to use eardrops before having microsuction. This resulted in the tinnitus becoming louder. He wrote a letter of complaint to a medical board. They replied saying there is no medical evidence that microsuction can make tinnitus worse and they believe it is the best and safest method of removing earwax, especially when it is impacted.

Michael

 

[Bill Bauer]

They replied saying there is not medical evidence that microsuction can make tinnitus worse

They make it sound like studies had shown the result above. Of course the reality is that no studies had been done to produce the evidence...

 

[Michael Leigh]

HI @Bill Bauer

Please see below a copy of a post from someone I know at another forum, just to prove I am not making up stories. For obvious reasons I have omitted the person's name. This person is replying to someone that had microsuction at a private clinic (something I don't recommend) but wasn't advised to apply eardrops to soften the wax before the procedure

and yet another soul suffers as a result of this procedure. I have taken my case both to my GP and the medical ombudsmen, and upon investigation they maintain there is no medical evidence to suggest these procedures cause tinnitus. stuck with T a year and a half on, which has affected every area of my life.

 

[Tom Riordan]

Thank you all so much for your responses. I'm glad there is a community here to discuss this condition.

@Bill Bauer

I agree -- I think physicians should warn patients more readily, and the study should be used as objective evidence of why this procedure is ultimately way more unsafe than is let on-- it has the potential to produce noise next to the ear drum that is far passed the threshold of pain and damage. (https://www.ncbi.nlm.nih.gov/pubmed/22218937)

@PortalNaut

After looking into it:

Ear Canal: 2.5 Centimeters
Closed Tube Resonance 0f 2.5 Centimeters at Room Temperature: 3443.777777777778 Hz

^^^ This is precisely the range of my tinnitus.

 

[dingaling]

A procedure like microsuction is usually very safe in competent and experienced hands.

 

[Michael Leigh]

A procedure like microsuction is usually very safe in competent and experienced hands.

I have every confidence in microsuction having had it three times without any problems. People usually have problems when the earwax is not completely softened using olive oil eardrops. This should be applied to each ear 3x a day for 7 to 10 days before having microsuction. Another problem as you rightly say, is when this procedure isn't carried out with due care and attention by someone competent to do so. It is for this reason, I recommend a person has microsuction done at a hospital ENT department and not at a private clinic advertising their services on the Internet.

Michael

 

[Bill Bauer]

A procedure like microsuction is usually very safe in competent and experienced hands.

The above is true when it comes to healthy, T-free people. It is less safe for people who are already suffering from T, whose ears had been compromised. For them, this procedure is just "reasonably safe." But keep in mind that playing Russian Roulette is also reasonably safe (only a 1 in 7 chance of being hurt).

 

[Bobby B]

I went to two clinics to get an ear full of debris removed after my outer ear infection

Both used a special deep probe camera and removal was done with small metallic hand pliers and nothing else was used

One offered to suck air at some point to clear the dust but I categorically refused so he spent more time wiht the pliers and no harm was done

That is what I would be doing for wax removal but I never had wax issues

If the ent is willing to spend time doing it manually wiht pliers and has the camera setup there will be no damage - if they offer these lazy quick and easy methods of succion just walk away

If you wear plugs for extended time I would rinse the ear canals on a regular basis with a liquid made of 50% white apple vinegar and 50 % ethanol

 

[Bill Bauer]

50 % ethanol

Is ethanol the same as rubbing alcohol? Isn't it ototoxic?

 

[Bobby B]

Not the same
Rubbing alcohol is isopropyl alcohol
Both aren't ototoxic though

 

[Vicki14]

Moral of the story-- and I hope for any ENT professionals reading this-- micro-suction is DANGEROUSLY over-promoted as the safest method for ear cleaning. It seems to me that quite the opposite is true when it comes to serious wax blockages. The devices used are far to brutish -- the suction is too powerful and the opening too large-- in relation to the tympanic membrane the suction tube seems too big. The vacuum created by a total blockage can further amplify the transmission of high pressure into the ear when the blockage is penetrated (CRACKLE POP!)

Hi, I read your post and could sadly relate as will @Blue28 . I absolutely agree with everything you have said. I was also told MS was the 'safest form' of wax removal by a brutish Audiologist. It absolutely enrages me that they have absolutely no clue in what damaging effects this has on our ears and we have no comeback from this. I tried twice to sue the idiot who performed mine and was told there wasn't enough evidence!! I truly hope your ears settle.. take care xx

 

[Blue28]

Hi @Tom Riordan

I'm totally in agreement with you and @Vicki14, microsuction is so dangerous when not performed with the utmost of care. I have suffered hearing loss, chronic tinnitus, hyperacusis and SO SO much more at the hands of an ENT who when I complained has made me out to be a liar and a person with deep psychological issues... Neither of those things are true. This guy has ruined my life and is getting away with negligence... It ENRAGES me!

 

[dpdx]

I woke up one morning with a completely wax clogged right ear. This had happened before, so I was not too panicked--previously in my life I had flushed it out at general practitioners' offices with no harm or damage. I am a DJ and audio engineer, so I frequently wore ear plugs and was aware of the dangers of loud environments.

The ENT I decided to go to proceeded to use micro-suction to remove the wax. This experience was 1. Painful and 2. LOUD. I was sitting in the chair nervous, with the feeling that "The Dr. knows what they are doing, but I shouldn't be feeling this...I feel like my ear is going to pop"

After the wax was removed, something wasn't right. I am an audio engineer and can pick apart frequency bands well, without hearing tests -- I knew that the "wind noise" above 10k had disappeared in that ear completely. They proceeded to test my hearing, telling me everything was "perfectly fine"... but it clearly was not. I could hear upper frequency sine waves they were playing, but the higher frequency bands that give vocals and wind noises breathiness and air had disappeared.

Additionally, in the vocal range from about 1k-4k I now experience ultra sensitivity in my right ear--somewhat of a narrow band "notch filter" effect that some other audio engineers might be familiar with when EQing sources. It sounds like distortion. The higher frequencies above 10k are gone completely.

Since then, I've found vigorous exercise and avoiding salt helps-- sometimes the tinnitus subsiding completely. I've also found that ironically store bought ear plugs make my ears ring terribly the next day, and on the nights where I leave the plugs out my ears feel OK the next day.

This counter-intuitive experience has led me to believe that earplugs can create a resonant cavity in the ear canal, which hyper-amplifies certain frequencies, which end up vibrating the entire ear structure sympathetically. (IE open tube vs. closed tube resonance)

Another counter-intuitive experience I have had is that loud, subsonic frequencies played over headphones cause the ringing to subside for a while--my theory is that the low frequencies vibrate the liquid in the cochlea, giving temporary rise to certain cilia that are otherwise flattened and dead--like giving the cochlea a deep massage. This is speculative, but my experience has shown this many times.

Fast forward two years-today I went to an ENT for the same problem I went to last time. but this in the left ear this time. I explained my experience that the last ENT had most likely given me tinnitus, but I didn't speak up when he brought out the micro-suction tube. I screamed in pain as he sucked the wax from my inner ear canal, which I was scolded for "Alarming the other patients". I was told to calm down, and I was told the canal was clean, while repeatedly mentioning that it felt like my ear was still blocked. I broke down in the office and began panicking. I put my face in my hands.

Now I am sitting here hours later, and while I do not have ringing in my left ear it sounds like I am holding up a sea-shell to my ear, and it is filled with cotton. When I close the ear, a brief white noise can be heard and then re-adjusts to a silent baseline (a good sign hopefully). When my ear is opened, the shell noise persists --it also seems that certain frequency bands are being attenuated in the upper mid-range, and the highest white noise "ocean" sounding frequencies are being amplified from my inner ear to compensate. When I open the ear up again, it sounds normal, but slowly the inner ear adjusts and begins pumping high frequencies again--once again the feeling of a blockage persists.

Moral of the story-- and I hope for any ENT professionals reading this-- micro-suction is DANGEROUSLY over-promoted as the safest method for ear cleaning. It seems to me that quite the opposite is true when it comes to serious wax blockages. The devices used are far to brutish -- the suction is too powerful and the opening too large-- in relation to the tympanic membrane the suction tube seems too big. The vacuum created by a total blockage can further amplify the transmission of high pressure into the ear when the blockage is penetrated (CRACKLE POP!)

I am trying not to be distraught until a few days to see if this clears up, but I am very worried. To the ENT's reading this, please use smaller suction tubes with adjustable suction (if it exists), or not at all. I now sit here with a ringing in my right ear and sea-shell on my left-- I'd rather have both ears clogged shut for life if this persists.

My final thought for medical professionals -- listen to your patients. Still very little is known about the ear, and you should recognize that and take our input and anecdotal experience very seriously, and continue to take those stories and share them to those who are engaged in research. I feel I have been steamrolled by the ENT's I've come in contact with -- let us not forget the medical device sales people who most likely promoted micro suction in the first place. Praying this subsides.

ENTs and Audiologists are garbage. They think this is game well its not. T is awful and it can destroy a person completely.I had perfect hearing but after I did the VEMP Test at an audiologist office I lost 20db of my hearing. They played 100-110db of loud clicks for 2-3 minutes. This can cause any person to have hearing loss with T or not T. now I am struggling here with a high pitched dentist drill tinnitus and severe hyperacusis.