LLR Policy for Ear Wax Removal

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Category

Threshold Criteria

Wax is an important and natural secretion found in the ear. It keeps the ear canal lubricated and protects the ear against dust, dirt and bacteria, which helps to prevent infection.

Eligibility

LLR ICB s will only fund secondary care treatment where the following criteria is met
 
·       The person has (or is suspected to have) a chronic perforation of the tympanic membrane or healed perforation
OR
·       There is a past history of ear surgery
OR
·       There is a foreign body with ear wax (including vegetable matter) in the ear canal
OR
·       The patient is suffering from significant symptoms due to ear wax build up including hearing loss or pain and the patients’ condition warrants micro suction
OR
·       Has a recent history of Otalgia and/ or middle ear infection (in the past 6 week)
OR
·       Has had previous complications following ear irrigation including perforation of the ear drum, severe pain, deafness or vertigo
OR
·       Two attempts at irrigation of the ear canal in primary care are unsuccessful
OR
·       Removal of ear wax in patients who have already had ear irrigation in primary care and need complete removal of any residual wax prior to hearing aid fit
OR
·       Ear canal stenosis
OR
·       Active skin condition of ear, eczema, psoriasis
OR
·       Recent head injury
OR
·       Wax in only hearing ear (do not irrigate)
OR
·       If ear wax is totally occluding the ear canal and any of the following are present
o   Hearing loss
o   Earache
o   Tinnitus
o   Vertigo
o   Cough suspected to be due to ear wax
o   Tympanic membrane is obscured by wax but needs to be viewed to establish a diagnosis
o   If the person wears a hearing aid, wax is present and an impression needs to be taken of the ear canal for a mould, or if wax is causing the hearing aid to whistle

Guidance

Overview | Hearing loss in adults: assessment and management | Guidance | NICE
ARP 32 Review Date: 2026

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5 responses

  1. Could one of your staff indicate a time frame for urgent referral to micro suction process. My GP has made an urgent request on my behalf after a recent consultation. Thank you

  2. Do you only commission this via secondary care – do primary care or community provide against this criteria as well?

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