Q:How safe is syringing of the ears? I seem to develop wax constantly and need a good clearing out of the ears from time to time, but I've heard that it could perforate the eardrum. M S, Watford...........
A:This question was recently posed by a study team from Copenhagen, which set out to measure how much pressure is actually generated during syringing. In order to test it, the researchers carried out their operation on people who'd died within 48 hours (it's not clear if they got the consent of relatives beforehand).
The researchers then simulated what would be forceful syringing of one ear on each study subject, and measured pressure in the canal during the procedure with a special instrument. The Copenhagen researchers found that the pressure ranged between 150-300 mm Hg, with an average of 210 mm Hg, but higher pressure in areas where the ear canal was wide (285 mm Hg on average).
The type of syringe also influenced the pressure, with metal causing the most pressure and a rubber balloon the least.
In order to simulate wax in the ears, the researchers then put a piece of well chewed chewing gum into the ear, but this made no difference to the readings (but it does make you wonder what they do to our bodies after death).
Earlier work by the same group showed that pressure was in the range of 383 to 1520 mm Hg, so the risk of puncturing the ear by pressure alone is very small. As these tests were carried out on old people, the risks may be even lower among the young.
The risk of puncture by the tip of the syringe is also low, as it would have to be inserted 4cm into the canal.
Wax does not increase the risk, but it may conceal the eardrum, which may be perforated or atrophied. If it is, syringing can be dangerous and there is no way for the specialist to know beforehand.
The research team discovered that an atrophied eardrum could be perforated at much lower pressure levels of around 228 mm Hg.
Quite a number of patients claim their ears were perforated by syringing, while studies have shown that 3 per cent of perforations were caused by ear irrigation. Nothing in the Copenhagen study disproves these views.
So are there safer alternatives? The wax can be softened beforehand by various oils available from the chemist. It should be the precursor to any syringing which should be considered only as a last resort. An "alternative" oil that can be used to soften the wax is Levisticum.
If syringing does concern you, your GP or nurse should also have a long spoon like instrument which can be used instead. It is a more laborious process, but it should be safer. Another possibility is the Hopi ear candle which involves a convection process to help ease inflamed and infected ears.
Many people use "self help" remedies, such as the use of cotton wool tips to clean out the ear. But, when doing this, you need to remember that the ear is naturally pushing out wax and dead skin all the time. A forceful prodding action can actually push the wax back into the ear, so adding to the buildup. These tips should be used sparingly, and then with the lightest of touches. Clean the sides of the ear only, without pushing the tip in too far, and use a twirling motion between your fingers which is a safer and more effective method of cleaning.
Ear wax is a natural and necessary function of the ear as it provides protection to the drum. But if your ears are regularly producing excessive amounts of wax, you should suspect a food allergy, such as sugar, which may also be causing a buildup of mucus.