An audiologist is a healthcare professional who focuses on hearing and balance disorders and often performs cerumen management (earwax removal). Their involvement in removing earwax is typically not for general hygiene but for specific clinical reasons related to their primary scope of practice. This procedure becomes necessary when an earwax blockage, known as impaction, interferes with a patient’s hearing, prevents proper diagnostic testing, or causes issues with the use of hearing devices.
Cerumen Management and Hearing Health
Audiologists focus on cerumen primarily when it impedes the accurate assessment of a person’s hearing ability. A significant buildup of earwax can create a temporary, conductive hearing loss by completely blocking the path of sound waves traveling to the eardrum. If the ear canal is even partially blocked, it can skew the results of audiometric testing, making it impossible to determine the true extent or type of hearing loss present.
For individuals who use hearing aids, cerumen management is particularly important for maintaining the device’s function and longevity. Earwax can clog the small microphones, receivers, and vents of hearing aids, which can lead to reduced sound quality, total device malfunction, or an irritating whistling sound called acoustic feedback. The physical presence of a hearing aid mold or dome in the ear can also stimulate the cerumen glands, sometimes leading to a faster rate of wax accumulation.
Professional Earwax Removal Methods
Audiologists use specialized techniques to remove impacted earwax safely under direct visual guidance. One common method is micro-suction, which uses a miniature vacuum pump and a fine suction tube to gently draw the wax out. This procedure is performed while the audiologist views the ear canal through a microscope or specialized loupes, allowing for a precise and low-risk extraction.
Manual removal, also known as curettage, uses thin, specialized instruments, such as a cerumen curette or small forceps, to scoop or pull the wax out. This method is typically reserved for wax that is close to the outer part of the ear canal or for wax that is particularly hard or dry. The third approach is irrigation, which uses a controlled stream of warm water or saline solution delivered by a specialized machine to flush the softened wax out of the ear canal.
Irrigation is avoided if the patient has a perforated eardrum or a history of specific ear surgeries, as introducing fluid could cause infection or discomfort. Before any removal, the audiologist performs an initial examination with an otoscope to assess the wax and the health of the ear canal and eardrum. This visual assessment determines the safest and most effective method for the specific type of impaction.
Audiologists Versus Other Healthcare Providers
While audiologists are experts in hearing and trained for cerumen removal, they are not the only professionals who perform this procedure. Primary Care Physicians (PCPs) often handle routine or minor earwax removal using irrigation or manual methods during a standard office visit. However, PCPs may not always have the specialized equipment, such as a surgical microscope, that audiologists and ENT specialists use for more complex extractions.
Otolaryngologists, commonly known as ENT doctors, are medical doctors specializing in the ear, nose, and throat, managing all medical and surgical conditions of the ear. An audiologist will refer a patient to an ENT if the cerumen removal is complex, such as when the wax is deeply embedded, or if the patient has underlying medical conditions that increase the procedure’s risk. These conditions include a perforated eardrum, a recent ear infection, chronic drainage, or significant pain or bleeding.
ENTs are the appropriate choice when there is suspicion of a foreign body, a tumor, or when the patient has a history of ear surgery, which complicates access to the ear canal. The key difference is that audiologists focus on the hearing-related implications of earwax, while ENTs address the medical and surgical management of the ear structure itself. Audiologists and ENTs often work collaboratively to ensure a patient receives the appropriate level of care, especially when a medical issue is suspected.