Definition 

Ear irrigation is a procedure that involves gently flushing the external ear canal with a stream of warm, sterile water or saline solution. The purpose is to remove accumulated earwax (cerumen), foreign objects, or debris.

Ear syringing or ear lavage are terms sometimes used for similar procedures, but they may involve a larger volume of water or a more forceful stream delivered with a syringe.

Aims/Purposes of Ear Irrigation

• Remove Earwax: The most common reason for ear irrigation is to remove impacted or excessive earwax that may be causing hearing loss, discomfort, or other symptoms.

• Remove Foreign Objects: To dislodge and remove small foreign objects from the ear canal.

• Cleanse the Ear Canal: To remove dirt, debris, or other substances from the ear canal.

Indications for Ear Irrigation

1. Impacted Earwax: To soften and remove hardened earwax.

2. Foreign Body Removal: To dislodge certain foreign bodies (excluding objects that swell with water, such as organic matter, or tightly wedged objects).

3. Otitis Externa (Swimmer’s Ear): To cleanse the ear canal and remove debris associated with this outer ear infection.

4. Chronic Otitis Media with Effusion (Glue Ear): To cleanse the ear canal in cases of purulent discharge.

5. Pre-Surgical Preparation: To clean the ear canal before certain ear surgeries.

6. Hearing Test Preparation: To remove debris that could interfere with hearing test accuracy.

7. Ear Mold Impression Removal: To help remove a mold impression after it’s been taken.

8. Ear Pressure Relief: To relieve pressure related to altitude changes.

9. Localized Inflammation and Discomfort: To soothe inflammation and discomfort in the ear canal.

10. Antiseptic Application: To deliver antiseptic solutions to the ear canal.

11. Therapeutic Heat or Cold: To apply warm or cold water for therapeutic purposes.

12. Vestibular Function Testing: To aid in assessing the inner ear’s balance system (e.g., during a bi-thermal caloric test).

Contraindications for Ear Irrigation

1. Perforated Eardrum: A hole in the eardrum is a strict contraindication, as fluid could enter the middle ear and cause infection or further damage.

2. Active Ear Infection: Irrigation may worsen pain, inflammation, and potentially spread the infection in cases of acute or severe ear infections.

3. Recent Ear Surgery: Irrigation could disrupt the healing process after ear surgery.

4. History of Ear Surgery: Certain ear surgeries, like the placement of ventilation tubes, may make irrigation unsafe.

5. Severe Pain or Discomfort: If the procedure causes significant pain, it should be stopped immediately.

6. Certain Medical Conditions: Conditions like diabetes, weakened immune systems, or certain skin conditions may increase the risk of complications.

7. Presence of Grommets: Irrigation is contraindicated if the patient has grommets in place.

8. Unable to follow instructions Irrigation should not be done if the patient is uncooperative or unable to follow instructions.

Prescribed Solutions

• Boric acid 2-4% solution

• Sodium bicarbonate solution 1%

• Normal saline

• Hydrogen peroxide 2%

• Sterile water

• Warmed to body temperature.

Equipment

• Tray: To hold the necessary supplies.

• Ear Syringe in a Receiver: (Or another appropriate irrigation device).

• Auroscope: To examine the ear canal.

• Basin and Vomitus Bowl: For collecting the irrigation fluid.

• Receiver: For collecting used supplies.

• Clean Gloves

• Waterproof Cape: To protect the patient’s clothing.

• Patient’s Towel

• Cotton Swabs

• Prescribed Solution (as listed above)

• Bowl of Warm Water: To warm the solution to body temperature.

• Adjustable Light and Screen: For adequate visualization and patient privacy.

• Plastic Apron

• Handwashing Equipment

Procedure for Ear Irrigation