CHFT: MANAGEMENT OF EAR WAX PATHWAY ←Click to view pathway image Source of image goes here Earwax contributing to hearing loss, blockage or irritation, or Earwax preventing examination of the ear, a hearing test or hearing aid assessment ↓ Olive oil or wax-softening drops for 2 weeks Earwax Patient Information Leaflet NOTE: Olive oil drops are useful for softening wax. If not clearing, sodium bicarbonate or urea hydrogen peroxide drops are useful for breaking up and clearing wax. Wax cleared?NoYes ↓ Contra-indications to irrigation?NoYes NOTE: Contra-indications to irrigation Previous complications following ear irrigation Active infection or significant pain Recurrent or chronic otitis externa Perforated ear drum Mucoid discharge in the past 12 months (suggestive of perforated eardrum) History of ear surgery (except grommets that have extruded) History of cleft palate, repaied or not Hearing in only one ear, if it is the ear to be treated ↓ Ear irrigation (or other available method) in the community, with wax softening drops for 5 days beforehand. Post irrigation - wax cleared?NoYes ↓ If this fails, try again on another occasion with wax softening drops for 5 days beforehand. ↓ Wax still not cleared ⤷ ⤷ Continue Self-management Referral to Aural Care Clinic GP Guidance for Dewax Referral