Policy Number: SRP 042
Policy Name: Ear Microsuction for earwax removal
Status: Group Prior Approval
Effective Date: 1 April 2024
Next Review Date: 1 April 2026
First line treatment for earwax removal is self-management.
- First line: advise olive oil for two weeks to soften wax so that it falls out naturally.
- Second line: advise patient to use sodium bicarbonate drops (over the counter) for three to five days (unless perforated tympanic membrane, also warn patient about potential skin irritation).
- Advise patient to consider use of an ear bulb for removal of wax. This is safe and can be purchased from a pharmacy.
For people who are prone to ear wax build up, regular use of olive oil will soften wax so that it falls out naturally. For more information: http://www.nhs.uk/conditions/earwax/pages/introduction.aspx
Mid and South Essex ICB commissions ear microsuction for wax removal as part of ENT commissioned services (not as a standalone service) on a restricted basis for patients where GP documented self-management over a period of at least 3 months has failed and who meet one or more of the following criteria:
- Patients with contraindications to ear irrigation (tympanic perforation, previous ear surgery, history of otitis externa following syringing, young children uncooperative to ear irrigation)
- Acute or chronic otitis externa with excessive debris or swollen external meatus not settling after initial topical treatment or who require regular microsuction to prevent recurrent episodes.
- The patient has a cleft palate (repaired or not).
- Wax unresponsive to ear irrigation. Ear irrigation must have been attempted and documented as failed on at least two occasions before referral for ear micro-suction on each occasion.
- Ear foreign body extraction
- Regular mastoid cavity de-waxing
Routine repeated ear micro-suctioning to prevent ear wax build up will not be funded.
Patients not meeting the above criteria will not be funded unless there are clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Find out more information on applying for funding in exceptional clinical circumstances.