Otolaryngology Book

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Warm Water Ear LavageAka: Ear Lavage, Ear Irrigation

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  1. Indications
    1. Cerumen Impaction
  2. 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
  3. Precautions: Avoid forceful irrigation
    1. Risk of Tympanic Membrane Rupture
    2. Risk of ossicle trauma
    3. May further impact cerumen
  4. 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
      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
  5. Technique
    1. Retract pinna posteriorly
    2. Use moderate pressure (AVOID forceful irrigation)
    3. Direct fluid to superior canal or other opening in wax
  6. Efficacy
    1. Effective in 70% of cases

Irrigation of ear (C0149534)

ConceptsTherapeutic or Preventive Procedure (T061)
ICD996.52
EnglishAural canal syringing, Ear syringe, Ear syringing, Flushing of ear, Irrigation of ear, Irrigation of external auditory canal, Syringing of ear
Spanishirrigación del oído, irrigacion del oido
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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