Earwax build-up causing hearing loss should be removed in primary care

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In a new draft guidance, National Institute for Health and Care Excellence (NICE) has recommended removal of earwax at GP surgeries or community clinics if the build-up is affecting hearing. The new recommendation means patients need not be referred to a specialist ear, nose and throat service for earwax removal and the procedure may be done in primary care.

The guidance recommends use of ear irrigation which involves pumping water at a controlled pressure by means of an electronic pump. The wax may be softened using ear drops before the procedure. Ear syringing using manual syringe is potentially dangerous and not recommended. Other acceptable methods include microsuction and manual removal; however, microsuction requires appropriate training and equipment.

Early and appropriate management of hearing issues is particularly important for those with learning or cognitive difficulties, which may make them unaware of their hearing loss. Patients with hearing issues not related to earwax or an infection should be referred to an audiology service. In case of an unobvious cause of hearing loss, referral to a specialist service or an emergency department should be sought promptly.

"Referring individuals with hearing loss symptoms to the right service at the right time will help improve care," Professor Mark Baker, Director of the centre for guidelines at NICE, commented.