An ear wick is a compressed sponge or gauze material designed to deliver medication deep into the external ear canal when it is severely swollen from an infection like otitis externa, commonly known as “Swimmer’s Ear.” The wick acts as a physical channel, wicking prescribed antibiotic or steroid drops past the narrow, inflamed opening to the site of infection near the eardrum. This procedure is a medical intervention, typically performed by a trained healthcare professional, and should not be attempted by a layperson. Placement occurs only after a medical diagnosis confirms the need for this specific drug delivery.
Understanding the Need for an Ear Wick
Severe otitis externa causes significant inflammation and swelling of the external ear canal lining. This swelling can lead to canal occlusion, where the ear canal closes almost completely. When this occurs, standard topical ear drops cannot penetrate past the blockage to reach the infected tissue deep inside the canal.
This inability of liquid medication to reach the infection site is the primary indication for an ear wick. The wick, often made of compressed cellulose or a similar hydrophilic material, is inserted while dry. Once medication is applied, the wick expands, gently stenting the canal open and maintaining a continuous path for the medication.
The wick ensures the topical medication is delivered to the entire length of the inflamed canal and provides prolonged contact time between the drug and the tissue. For mild cases of otitis externa where the canal is still visibly open, ear wicks are typically unnecessary, and drops can be administered directly.
Materials and Patient Preparation
Necessary supplies include the sterile ear wick, the prescribed topical medication, an otoscope for visualization, and a specialized instrument like bayonet or alligator forceps for insertion. Adequate lighting is also essential to ensure the healthcare provider has a clear view of the narrow ear canal.
Patient preparation starts with positioning, usually involving the person lying on their side or tilting their head so the affected ear is facing upward. Before insertion, a thorough cleaning, or aural toilet, is often performed to clear the ear canal of any inflammatory debris, discharge, or obstructing earwax.
This initial cleaning is crucial because it removes material that can inactivate the medication and ensures the wick can be inserted without being blocked. If the canal is extremely tender or swollen, the cleaning may be done with gentle suctioning under microscopic guidance. Once the canal is cleared, the healthcare provider can proceed with the insertion.
Technique for Inserting the Ear Wick
The procedure begins with the healthcare provider visualizing the ear canal using an otoscope, which confirms the absence of debris and the degree of swelling. The sterile, compressed wick is then grasped near its tip using the forceps. Insertion requires precision and gentle handling to avoid causing trauma to the already inflamed tissue.
To straighten the natural curve of the ear canal, the provider must gently manipulate the outer ear, or pinna. This involves pulling it up and backward for adults, or down and backward for young children. The wick is then slowly and carefully advanced into the canal, following the direction of the straightened passage.
The wick must not be forced past any significant resistance, as this could damage the canal lining. The goal is to place the wick deep enough to bypass the area of maximum swelling, yet leave a small “tail” visible at the entrance of the ear canal. Once positioned, the final and most important step is to “prime” the wick by applying the prescribed topical medication directly onto the exposed portion.
Post-Insertion Care and Removal
Once the ear wick is positioned, patient care focuses on maintaining drug delivery and promoting healing. The patient or caregiver is instructed to keep the wick saturated by applying the prescribed ear drops directly onto the exposed end, typically three to four times per day. This continuous application ensures the medication is constantly delivered to the infected site and keeps the wick expanded.
Patients must be diligent about keeping the ear dry, avoiding water exposure from showering or swimming, which can compromise the treatment. The wick is generally left in place for 48 to 72 hours, though sometimes up to four days, depending on the severity of the swelling.
Often, the wick will fall out spontaneously as the canal returns to its normal size, indicating that the inflammation has decreased. If the wick does not fall out, it must be removed by a healthcare provider at a follow-up appointment. Even after removal, patients may need to continue the ear drops for a total course of seven to ten days to fully eliminate the infection.