Micro Suction Ear Wax Removal Consent Form

In order to remove ear wax / debris from your ear canals it is necessary to carry out otoscopy (visual inspection of the outer ear, canal and ear drum) and remove from your ear using the safest and most appropriate method for the location and amount of wax discovered. Three methods of wax removal may be used:

  1. Microsuction – a system which effectively uses a vacuum to clear out any debris or wax from the ear canal. The suction unit we use was originally designed to remove fluids from the airway or respiratory support system and infectious materials from wounds and has been adapted for aural micro suction. A fine suction tube is gently inserted into the ear canal while being viewed closely through a magnifying Loupe headset.
  2. Water Irrigation – an effective method to remove debris or wax in cases of a healthy ear canal and intact eardrum. The water irrigator unit we use has been designed specifically for ear wax removal. With irrigation we aim low pressure pulses of water to flush out the ear canal. The water is around body temperature (37˚C).
  3. Dry Removal – (Jobson Horne probe / Henkel & Crocodile Forceps) – The Jobson Horne probe is a thin metal instrument with a small circular loop on the end. We also use other similar curette instruments and forceps with various tips for gentle removal of wax and other debris close to the ear canal entrance.

All our staff have undertaken training in debris and wax removal and will use best-practice procedures to minimise any risk of harm. However, as with any wax removal procedure, even when performed with the utmost care, there is a small risk of damage to or infection of the skin of the ear canal or the eardrum. Furthermore, the procedures of microsuction and water irrigation can be noisy and may cause a temporary shift in your hearing thresholds or start / aggravate any existing tinnitus. There is also the risk of temporary dizziness or discomfort. In certain instances, olive oil may be used during the procedure, unless there is a known sensitivity. Finally, where it is not possible to remove the wax, you may be advised to use further treatment with olive oil before arranging a further visit.

If you are happy with all the above and wish to proceed please indicate consent by ticking the consent box and information requested below.

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To ensure we safely remove any wax or foreign bodies present within the ear canal it is important that your clinician is made aware of anything which may have a bearing on the procedure.

Please answer to the best of your knowledge, and note that based on the responses you give this may point to a more appropriate treatment to address your needs. If unsure on any detail or you have any concerns / discomfort with our treatments and procedures (beforehand or during) please inform us immediately.

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In order to remove ear wax / debris from your ear canals it is necessary to carry out otoscopy (visual inspection of the outer ear, canal and ear drum) and remove from your ear using the safest and most appropriate method for the location and amount of wax discovered. Three methods of wax removal may be used:

  1. Microsuction – a system which effectively uses a vacuum to clear out any debris or wax from the ear canal. The suction unit we use was originally designed to remove fluids from the airway or respiratory support system and infectious materials from wounds and has been adapted for aural micro suction. A fine suction tube is gently inserted into the ear canal while being viewed closely through a magnifying Loupe headset.
  2. Water Irrigation – an effective method to remove debris or wax in cases of a healthy ear canal and intact eardrum. The water irrigator unit we use has been designed specifically for ear wax removal. With irrigation we aim low pressure pulses of water to flush out the ear canal. The water is around body temperature (37˚C).
  3. Dry Removal – (Jobson Horne probe / Henkel & Crocodile Forceps) – The Jobson Horne probe is a thin metal instrument with a small circular loop on the end. We also use other similar curette instruments and forceps with various tips for gentle removal of wax and other debris close to the ear canal entrance.

All our staff have undertaken training in debris and wax removal and will use best-practice procedures to minimise any risk of harm. However, as with any wax removal procedure, even when performed with the utmost care, there is a small risk of damage to or infection of the skin of the ear canal or the eardrum. Furthermore, the procedures of microsuction and water irrigation can be noisy and may cause a temporary shift in your hearing thresholds or start / aggravate any existing tinnitus. There is also the risk of temporary dizziness or discomfort. In certain instances, olive oil may be used during the procedure, unless there is a known sensitivity. Finally, where it is not possible to remove the wax, you may be advised to use further treatment with olive oil before arranging a further visit.

If you are happy with all the above and wish to proceed please indicate consent by ticking the consent box and information requested below.

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To ensure we safely remove any wax or foreign bodies present within the ear canal it is important that your clinician is made aware of anything which may have a bearing on the procedure.

Please answer to the best of your knowledge, and note that based on the responses you give this may point to a more appropriate treatment to address your needs. If unsure on any detail or you have any concerns / discomfort with our treatments and procedures (beforehand or during) please inform us immediately.

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For general information, enquiries & bookings please call 0800 999 5992 or email us at: info@naturalhearing.co.uk