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Let me tell you about Mrs. Patterson. She came to our clinic last month after having her ears syringed at her GP surgery. The procedure hadn't worked—the wax was still there, her hearing was still muffled, and now she had a new problem. Water was trapped behind the wax, creating an uncomfortable sloshing sensation every time she moved her head. She'd been told to wait a few days for the water to drain, but it wasn't draining. It was just sitting there, making her miserable.
We removed the wax with microsuction in about ten minutes. The relief was immediate. Her hearing returned, the trapped water was gone, and she looked at me with a mixture of gratitude and frustration. "Why didn't they just do this in the first place?" she asked.
It's a good question. And the answer reveals a lot about how ear care has evolved—and how some practices have been slow to catch up.
The Old Way: Ear Syringing
Ear syringing, also called ear irrigation, has been around for decades. The concept is straightforward. You squirt water into the ear canal at pressure, hoping to dislodge and flush out the wax. It's simple, it's cheap, and for many years, it was the standard approach to earwax removal.
The procedure uses a large syringe or an electronic irrigator to direct a stream of warm water into your ear canal. The water flows around the wax, creating pressure that's meant to break up the blockage and wash it out. The water, along with the dislodged wax, then drains out of your ear into a collection basin.
When it works, it works reasonably well. The wax comes out, your hearing improves, and you go home happy. But here's the problem. It doesn't always work. And when it doesn't work—or when it goes wrong—the consequences can range from uncomfortable to genuinely harmful.
Why Syringing Falls Short
The fundamental issue with syringing is that it's a blind procedure. The person performing it can't see what they're doing. They're directing water into your ear canal and hoping for the best, with no direct vision of where the wax is, how much there is, or what's happening as they work.
This blind approach creates several problems. The water pressure can push wax deeper into your ear canal, compacting it against your eardrum rather than removing it. What started as a partial blockage can become a complete one. This happens more often than you might think, and it's exactly what happened to Mrs. Patterson.
Water can get trapped behind the wax, creating that uncomfortable, sloshing sensation. The trapped water takes days to drain—if it drains at all—and whilst it's there, it creates an ideal environment for bacterial growth. Many cases of swimmer's ear (otitis externa) develop after unsuccessful ear syringing.
The procedure can be messy and uncomfortable. Water goes everywhere—down your neck, on your clothes, sometimes even on the floor. The sensation of water being forced into your ear canal isn't painful exactly, but it's not pleasant either. Some people find it quite distressing, particularly if they're already anxious about the procedure.
Syringing requires preparation. You're usually told to use olive oil drops for several days before the appointment to soften the wax. This makes sense in theory—softer wax should be easier to remove. But in practice, the oil can make the wax swell, potentially worsening your symptoms before the appointment. And if you forget to use the drops, or if they don't work well enough, the syringing may not be effective.
The Safety Concerns
Beyond the inconvenience and limited effectiveness, syringing carries genuine safety risks. These risks are relatively small—serious complications are uncommon—but they're significant enough that many healthcare providers have moved away from the procedure entirely.
Eardrum perforation represents the most serious risk. The force of the water can rupture your eardrum, particularly if it's already weakened or if the wax has been pushed firmly against it. A perforated eardrum causes sudden, sharp pain, immediate hearing loss, and sometimes bleeding from the ear. Whilst most perforations heal on their own, some require surgical repair.
Ear canal damage can occur when the water stream hits the delicate skin lining your ear canal. The skin can become abraded or torn, causing pain and increasing the risk of infection. Some people develop chronic inflammation of the ear canal after repeated syringing.
Dizziness and vertigo sometimes occur during or after syringing. The water temperature might not be quite right—too cold or too warm—creating a temperature difference that affects your vestibular system. Or the water pressure might affect the middle ear through a small perforation you didn't know you had. The dizziness can be severe enough to cause nausea and vomiting.
Infection risk increases when water is introduced into the ear canal, particularly if the skin has been damaged or if water becomes trapped. The warm, moist environment provides ideal conditions for bacterial or fungal growth.
These risks aren't theoretical. They happen regularly enough that the National Institute for Health and Care Excellence (NICE) has issued guidance recommending that syringing should only be performed by trained healthcare professionals, and that alternative methods should be considered, particularly for people with certain risk factors.
The Modern Approach: Microsuction
Microsuction represents a completely different philosophy of ear care. Instead of forcing water into your ear canal and hoping for the best, microsuction uses a gentle vacuum to remove wax under direct vision. The practitioner can see exactly what they're doing throughout the entire procedure.
The technique uses a surgical microscope or endoscope to visualise your ear canal in detail. A small suction device, similar to the one your dentist uses to remove saliva, is carefully inserted into your ear canal. The practitioner can see the wax, position the suction tip precisely, and remove it piece by piece with complete control.
The procedure is dry. No water goes into your ear canal, which means no risk of trapped water, no mess, and no temperature-related dizziness. You stay dry throughout, and you can go straight back to your normal activities afterwards with no waiting period.
The precision of microsuction allows the practitioner to work around delicate structures, removing only the problematic wax whilst leaving the protective coating your ear needs. If your eardrum is visible, they can see it and avoid touching it. If there's a narrow section in your ear canal, they can navigate it carefully. This level of control simply isn't possible with syringing.
Why Microsuction Has Become the Gold Standard
The advantages of microsuction over syringing are substantial enough that it's now considered the gold standard in ear care. Let me walk you through why.
Direct vision changes everything. Being able to see what you're doing transforms ear wax removal from a hopeful procedure into a precise one. The practitioner can assess the wax before starting, plan their approach, and adjust their technique as they work. They can see if they're making progress, if there's more wax to remove, and when the job is complete.
Immediate effectiveness means you leave with clear ears, not with instructions to wait and see if it worked. There's no uncertainty, no need for follow-up appointments to check if the wax came out. You know immediately that your ears are clear because your hearing returns right away.
Safety profile is significantly better. The controlled, precise nature of microsuction reduces the risk of complications. Your eardrum is never subjected to water pressure. Your ear canal skin isn't exposed to forceful water streams. The temperature-related dizziness that can occur with syringing doesn't happen with microsuction.
No preparation required in most cases. You can book an appointment and have your ears cleared the same day, without spending a week using oil drops first. This is particularly valuable when you need urgent relief—when you're travelling soon, when you have an important event coming up, or when your symptoms are severe enough that you don't want to wait.
Suitable for more people because the dry nature of the procedure makes it safe for people who can't have syringing. If you have a perforated eardrum, previous ear surgery, a mastoid cavity, or recurrent ear infections, microsuction is usually safe whilst syringing is contraindicated. This makes it the only option for many people who need ear wax removal.
Comfortable experience for most people. Yes, you'll hear a suction sound—it's similar to the sound at the dentist, though higher pitched. Some people find this sound loud or unusual, but it's not painful. Most people find microsuction more comfortable than syringing, particularly those who've experienced both methods.
The Noise Factor
I should address the one aspect of microsuction that some people find challenging: the noise. The suction device creates a sound that's amplified because it's right next to your eardrum. Some people describe it as loud or unusual, though it's not harmful to your hearing.
Here's the thing about the noise. It lasts for minutes, not hours. The entire procedure typically takes 10 to 15 minutes, and the suction isn't continuous throughout that time. The practitioner works in short bursts, giving you breaks. And once it's done, it's done. There's no lingering discomfort, no trapped water, no waiting to see if it worked.
Compare this to the discomfort of syringing—the sensation of water being forced into your ear, the mess, the potential for trapped water that lasts for days. Most people who've experienced both methods prefer microsuction, noise and all.
If you're particularly sensitive to sound, let your practitioner know. They can work more slowly, take more frequent breaks, and help you feel comfortable throughout the procedure. Communication makes a huge difference.
When Syringing Might Still Be Used
I'm painting a pretty clear picture here: microsuction is better. But I should acknowledge that syringing still has a place in certain situations.
Some GP surgeries and healthcare settings don't have the equipment or trained staff to perform microsuction. In these settings, syringing may be the only option available. If you're in this situation, syringing is certainly better than leaving problematic wax in place, particularly if you're experiencing significant symptoms.
For some people with very soft wax that's not deeply impacted, syringing can be effective and quick. If the wax is already partially loose and just needs a gentle flush to remove it, syringing might work well.
Cost considerations sometimes come into play. Syringing equipment is cheaper than microsuction equipment, and the procedure can be performed by a wider range of healthcare staff with less specialised training. In resource-limited settings, this can make syringing the more practical option.
But here's my honest opinion, based on years of experience and thousands of procedures. If you have access to professional microsuction, it's worth choosing. The superior safety profile, effectiveness, and comfort make it the better option for the vast majority of people.
Making Your Choice
If you're facing the decision between syringing and microsuction, consider these factors.
Your ear health history matters. If you have any history of ear problems—perforations, infections, surgery, or chronic conditions—microsuction is the safer choice. The dry, controlled nature of the procedure reduces the risk of complications.
Your symptoms can guide the decision. If you have severely impacted wax, microsuction is more likely to be effective on the first attempt. If you've had unsuccessful syringing in the past, microsuction offers a different approach that may succeed where syringing failed.
Your comfort level counts. If you're anxious about the procedure, the precision and control of microsuction may help you feel more at ease. Being able to communicate with the practitioner throughout, and knowing they can see exactly what they're doing, provides reassurance that blind syringing can't match.
Urgency plays a role. If you need your ears cleared quickly—for travel, for work, or because your symptoms are severe—microsuction's immediate effectiveness and lack of preparation time make it the practical choice.
The Bottom Line
Ear care has evolved. We now have a method that's safer, more effective, and more comfortable than the traditional approach. Microsuction isn't perfect—no medical procedure is—but it represents a significant improvement over syringing for most people in most situations.
At Earwax Removal Devon, we've specialised in microsuction because we've seen the difference it makes. We've treated patients who've had unsuccessful syringing, patients who've had complications from syringing, and patients who simply want the most effective method available. The results speak for themselves.
If you're struggling with earwax buildup, you don't have to settle for outdated methods. Modern ear care is available, accessible, and remarkably effective. Book an appointment with us today and experience the difference that professional microsuction can make. Your ears deserve the best care available, and we're here to provide it.
