15/09/2025
ALWAYS USE A QUALIFIED AUDIOLOGIST: A CAUTIONARY TALE
Anybody can perform wax removal and they don't need to have any qualifications whatsoever. It is not yet a regulated service. It’s something that I repeat to my clients regularly, but when it comes to wax removal, always seek out a qualified audiologist.
The danger of this becomes apparent in the following story.
I was called out on a home visit recently to see an elderly lady who has become housebound due to experiencing dizzy spells, which led to a serious fall earlier in the year that resulted in a fractured cheek.
She called upon my services after noticing that she was unable to hear from her right ear, even when using her hearing aid.
When I first looked in her ears, it was apparent that she had a total blockage of wax in her right ear. There was a lot of wax in her left ear, but it wasn’t completely blocking the canal.
The wax was removed fairly easily with microsuction.
Following wax clearance, I had a closer look at her canals and eardrums to make sure that everything looked healthy. It was while performing this post-procedural check that I noticed something unusual in her right ear.
Upon questioning, she reported that she was still unable to hear from this ear, even though the wax had been removed.
There was a white mass just behind her eardrum that was causing the eardrum to bulge a little. This was completely absent from her left ear. To the untrained eye, it may not be noticeable or could easily be dismissed as something or nothing.
I immediately thought it looked like a cholesteatoma. A cholesteatoma is a collection of dead skin cells that forms in the middle ear (behind the eardrum). It’s a non-cancerous growth. If left untreated, it has the potential to become infected and can eat away the eardrum and the fragile bones of the middle ear, which contributes to a permanent hearing loss.
Worse still, if left unchecked, an infection resulting from a cholesteatoma can eat away into the skull and infect the lining of the brain leading to meningitis.
I wrote a letter to the client’s GP recommending an urgent referral to Ear, Nose and Throat at the hospital for further investigation and issued it to the patient to pass on to her GP as this would be the fastest route.
I was contacted by her husband the very next day to say that she had been urgently referred to neurology at the hospital, had been seen that very morning and had a scan where they confirmed a cholesteatoma as the diagnosis. They’re going to perform surgery as soon as possible.
The sad part of this story is that this lady had been suffering with symptoms of dizziness and hearing loss for over 12 months and had been to see someone else for wax removal twice within this timeframe and the cholesteatoma had been missed both times.
Before booking in for wax removal, always check the clinician’s credentials and make sure they’re an audiologist!
