Warm Water Ear Lavage

Aka: Warm Water Ear Lavage, Ear Lavage, Ear Irrigation

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II. Indications

  1. Cerumen Impaction

III. Contraindications

  1. Tympanic Membrane not intact
    1. Tympanostomy Tubes
    2. Tympanic Membrane Perforation
  2. Prior ear surgery or Radiation Therapy to area
  3. Severe Otitis Externa
  4. Sharp foreign objects in external canal
  5. Vertigo

IV. Precautions: Avoid forceful irrigation

  1. See Precautions in Manual Cerumen Removal
  2. Risk of Tympanic Membrane Rupture
  3. Risk of ossicle Trauma
  4. May further impact cerumen

V. Preparation

  1. Warm water (Body Temperature)
    1. Prevents Vertigo from caloric stimulation
  2. Additives
    1. Acetic Acid
      1. Prevents Pseudomonas overgrowth
      2. Add 1 part 5% acetic acid to 2 parts water
      3. Consider instilling after irrigation
    2. Detergent Effect
      1. Helps separate wax from ear canal
      2. Detergents
        1. Hydrogen Peroxide OR
        2. 1:750 benzalkonium chloride
      3. Dilute irrigant 1:1 with hydrogen peroxide
  3. Lavage apparatus
    1. Ear Bulb syringe or
    2. Syringe (20 to 50cc) with IV or butterfly tubing

VI. Technique

  1. Retract pinna upward and posteriorly
  2. Use moderate pressure (AVOID forceful irrigation)
  3. Direct fluid to superior canal or other opening in wax

VII. Efficacy

  1. Effective in 70% of cases

VIII. References

  1. Malaty (2018) Am Fam Physician 98(8): 525-9 [PubMed]

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Ontology: Irrigation of ear (C0149534)

Concepts Therapeutic or Preventive Procedure (T061)
ICD9 96.52
SnomedCT 150565009, 270953001, 66363008
English Irrigation ext auditory canal, Ear syringing, syringing ear, irrigation of ear, Syringe ear, ear irrigations, ear syring, ear syringing, ear irrigation, ear syringed, Ear syringe, Aural canal syringing, Ear irrigation, Syringing of ear, Irrigation of external auditory canal, Irrigation of ear (procedure), Flushing of ear, Irrigation of ear, ear syringe
Italian Irrigazione auricolare
Dutch oor uitspuiten, oorirrigatie
French Lavage d'oreille, Irrigation de l'oreille
German Ohrenspuelung, Ohrspuelung
Portuguese Lavagem do ouvido, Irrigação do ouvido externo
Spanish Irrigación del oído, irrigación del oído (procedimiento), irrigación del oído, Irrigación del conducto auditivo externo
Japanese 耳洗浄, ｼﾞｾﾝｼﾞｮｳ, ﾐﾐｾﾝｼﾞｮｳ
Czech Výplach ucha
Hungarian Hallójárat mosás, Fül irrigatio
Derived from the NIH UMLS (Unified Medical Language System)

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