TABLE 2. CAUTIONS FOR IRRIGATING WITH WATER
Exercise caution when irrigating with water in the following patient groups Rationale
Patient is taking anti-coagulants. The lining of the ear canal is delicate and there is a higher risk of bleeding so ensure trauma to the ear canal is avoided
Patient is diabetic The pH of wax in patients who have diabetes is higher than average increasing vulnerability to infection
Patient has tinnitus Although wax impaction can cause tinnitus, trauma to the tympanic membrane may exacerbate it
Patient has vertigo This is also a symptom of wax impaction but irrigation can trigger an episode so ensure appropriate water temperature and patient safety
Patient has had radiotherapy that has involved the ear canal A radiated ear canal can develop bony necrosis so wax should be removed before it becomes hard and trauma to the canal should be avoided
Checklist for ear irrigation with water