Accumulated wax is often present in a normal ear canal. It can prevent proper inspection of the skin lining the canal or ear drum, and its presence can interfere with diagnostic testing. Excessive wax blocking an ear canal can cause hearing loss and therefore affect the results of pure tone audiometry or interfere with the free passage of water during the caloric test. Flakes of wax may also block the small soft rubber ear probes used with tympanometry, Eustachian tube function and Otoacoustic emission testing.


Typically wax is removed by inserting a small suction device through a sterile plastic speculum using the microscope, a procedure termed microsuction. This is normally a painless procedure. Syringing the ear canals with clean warm water has been a traditional method for removing wax, but requires special care or this procedure may result in permanent damage to the ear. ENT surgeons are reluctant to recommend syringing because there may be underlying problems obscured by the wax, such as a perforated or weak ear drum, which significantly increases the risk of causing permanent damage or infection.