Colorado Springs

Audiology, Inc.




Phone  719.520.1155



Dr. Gene McHugh

Licensed Audiologist

in Colorado


Mountain Time USA


9:00 AM-5:00 PM

Closed Fridays


  Copyright 2021






What is earwax and why is it a problem?  It is normal for the skin in the ear canal to replenish, thereby cleaning itself by moving toward the outer opening of the ear canal. It mixes with cerumen glands in the outer one-third, breaks up and normally falls out. The mixture is called cerumen or earwax.  A little earwax is fine and actually has helpful medicinal qualities as it traps sand or dust particles before they reach the ear drum.  It also protects the outer part of the ear canal because it repels water, however, when cerumen abnormally accummulates rather than falling out, it can potentially interfere with sound reaching the eardrum.

      Cerumen problems affect between 2%-6% of the general population in the United States.  As the older cerumen reaches the opening of the ear, it usually dries out and falls away.  It is estimated 150,000 a week have their ears cleaned because of wax blockage. 

     Most audiologists have not been trained to use a binocular microscope (otomicroscopy); therefore, they use either a hand-held otoscope or video-otoscope.  They may attempt to remove cerumen in this manner, but this limits their ability to remove cerumen as safely and comfortably when compared to using an otomicroscope. 




     Training to remove cerumenAudiologists may clean ears, but training is important.  I was trained by two ear, nose and throat physicians (otolarygologists) on the correct procedures to extract cerumen, along with longterm management.  Both preferred the microscope to examine ears; therefore in our clinic, ear canals are likewise examined using a microscope.  This is referred as otomicroscopy  ("oto" meaning "ear").  
Manual removal.  If the cerumen can be removed using a curette or otoloop, this is the safest method and usually minimally uncomfortable to the patient.   The otoloop, shown  left, has a small angled loop.  The ear canal is much less sensitive along the top compared to the bottom.  The otoloop is positioned along the superior part of the canal, and the earwax is gently rolled out.  Sometimes it is possible to use alligator forceps to grab the cerumen and extract it.
Lavage and suction.  Only when necessary, we lavage the canal with tap water warmed to body temperature.  If the water is more than 3 degrees higher or lower than body temperature, the ear's organ for balance may be over-stimulated resulting in vertigo, albeit very slight.
Most cases are relatively easy to complete, however, if the cerumen impaction is beyond my comfort range, it may be necessary to refer the patient to a medical ear specialist.

Cost:  $25.00 per ear ($50.00 for both).  We do not file insurance, but you may use our super bill and submit it to your insurance carrier. It is important to note that cerumen removal is not usually covered by insurance.

References of articles and tutorials by Dr. McHugh:
  1. McHugh, E. & Traynor, R. Video Otomicroscopy, A New Vision in Cerumen Management, Hearing Review (May, 2009).   

  2. McHugh, E.  Upgrading cerumen management services to otomicroscopy or video otomicroscopy  Audiology Online, (2008)   

NOTE:  Pre-pandemic pictures shown below

Examples of manual removal using currettes and lavage (water).   In our office, the patient is able to watch the process.  While it would seem this is unnecessary or difficult for the patient, the fact is that it is helpful to both patient and clinician.  Rarely do patients prefer not observe the procedure.    



Manual removal of cerumen



Lavage with water going into basin



Tympanometry to verify normal eardrum mobility - only possible when earwax has been successfully excavated



Clinician and assistant completing lavage on the right ear





Tympanometry to verify successful removal of earwax and normal eardrum functional.  This patient noticed immediate iimprovement in hearing following the procedure.  He has been coming to me for the past 10 years.