Microsuction of the external auditory canal

For the treatment of

External ear conditions

Commissioning position

This intervention is commissioned for:

  • Clearance of obstructive materials that are causing conductive hearing loss OR
  • Removal of material that is obstructing the view of the ear canal or tympanic membrane and preventing adequate assessment OR
  • Removal of debris to aid in the resolution of external or middle ear infections OR
  • Removal of foreign bodies accidently inserted into the ear canal OR
  • Removal of local anaesthetics used as part of minor outpatient procedures e.g. Grommet placement or intra-tympanic injections OR
  • Clearance of the ear canal to facilitate a procedure OR
  • Clearance to enable effective use of a hearing aid or ear defenders (including taking an impression of the ear canal)

AND

Wax softening drops:

  • have been used but not resolved the problem OR
  • are contraindicated OR
  • are not relevant to the specific indication listed above.

 

Microsuction is not routinely commissioned for ear wax removal if none of the above criteria apply.

 

NB In accordance with policy 089, irrigation of the external auditory canal is not routinely commissioned.

Summary of rationale

The vast majority of patients presenting with impacted ear wax will be able to relieve any symptoms with self-management and over the counter medication. NICE does not recommend manual syringing for removing earwax. Ear syringing with a large metal syringe or similar obsolete equipment is potentially harmful. The design of the syringe and the inability to control the water pressure increases the risk of damage to the ear canal and tympanic membrane. Irrigation using an electronic ear irrigation machine, which pumps water into the ear at a controlled pressure, is safer. Microsuction is not without risks but is a safer intervention. Ear wax removal services are widely available privately.

References

Clinical Guidance on Microsuction of the External Ear Canal | ENT UK

CKS Earwax (NICE)

HNY policy 089-Irrigation-of-the-external-Auditory-Canal.docx

NG98 Hearing loss in adults: assessment and management (NICE)

Associated Pathways

Audiology Humber Ear Care Humber Ear wax York Hearing Loss Humber Tinnitus Humber Tinnitus York

Specialties

Ear, Nose and Throat York Ear, Nose and Throat North Yorkshire Ear, Nose and Throat Hull Ear, Nose and Throat East Riding Ear, Nose and Throat North Lincolnshire Ear, Nose and Throat North East Lincolnshire

Places covered by

  • East Riding
  • Hull
  • North East Lincolnshire
  • North Lincolnshire
  • North Yorkshire
  • Vale of York

Individual Funding Requests

Date created: 17/02/2026, 11:52
Last modified: 18/02/2026, 09:00
Date policy effective from: 01/02/2026
Date due for review: 28/02/2029