Ear wax

Criteria for routine specialist referral via CRS

Patients with ear wax causing significant hearing loss with contraindications to syringing. Contraindications to syringing in adults include:

  • uncooperative patients
  • perforated ear drum (past or present)
  • ear infection in past 6 weeks
  • grommet inserted currently or extruded within the last 18 months
  • prior ear surgery.

Notes regarding syringing:

  • Do not syringe hearing/better hearing ear if patient has unilateral deafness
  • Caution in patients with:
    • recurrent otitis externa or tinnitus
    • diabetes
    • who are immunocompromised.

Referral information required

All referrals must include comprehensive medical history, relevant test results, summary of treatment to date and:

  • results of otoscopic examination
  • results of hearing tests or state reason why not undertaken
  • impact on patient’s quality of life
  • reason why syringing is contraindicated.

Information about community management

Further information regarding primary care management of ENT conditions is available on the HealthPathways WA website. Please email the HealthPathways team to obtain the login details: healthpathways@wapha.org.au. HealthPathways are currently working on responding to the new criteria and will have all the ENT pathways adapted to WA as soon as possible.