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Ear Irrigation Explained Step by Step

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The Perfect Procedure for Clearing the Ear: Ear Irrigation

For adult and pediatric patients

There are many procedures for clearing, cleaning the ear. We’ll let you know the routine procedure that ENT use in the Emergency Department (ED) for ear irrigation.

With this procedure cerumen- ear wax and foreign objects are removed from the ear canal. To get more information about tools used for ear irrigation read this article here.

It is very beneficial and improves hearing and life quality of the patient.

Ear irrigation with syringe and angiocatheter setup








This is ”ear-rigation” on the budget. Useful for clearing out the small objects which can not be pulled out of the ear with a hook.

Equipment for low cost but specialized ear irrigation:

  • 14, 16 or 18 gauge cannula (needle removed and tip trimmed)
  • 20 or 60 mL ear syringe
  • Saline in the body temperature
  • Towels
  • Basin

How it’s done? (Step by step of ear irrigation procedure)

  1. Before the start, the patient must know about the possibility of him/her feeling a little bit uncomfortable during the irrigation. The feeling of pressure and cold wetness are common.
  2. The patient should be seated with a straight spine and slightly tilt head to the affected side of an ear. Head is stabilized with doctors non-dominant hand.
  3. The ear is pulled up and outwards to straighten the ear canal.
  4. A doctor prepares a basin of saline which is physiological temperature.
  5. 20 or 60 mL syringe connected to the cannula is used. The tip of the catheter is placed next to the ear to avoid the fluid coming from the ear- dipping down on the patient.
  6. Carefully the injection of the solution starts. It is very important to be careful, because of being too fast the Tympanic membrane can be ruptured.
  7. ”The liquid” stream is directed directly to the cerumen or foreign material direction. In the end, irrigation is done in all directions.
  8. Irrigation has to happen continually until removal of the cerumen or any foreign object.

Very important!

  • The procedure has to stop if the patient suddenly feels sharp pain.
  • It is possible that the Tympanic membrane is ruptured during the procedure.
  • Next to perforation of the eardrum other ”complications” can occur such as pain, deafness, vertigo, and tinnitus.


  • Use kidney-shaped Genesis basin
  • Very important is the use of correct water temperature. It should be body temperature! Cold water can cause the patient to feel sick (nausea, vertigo, vomit).
  • Possible to use low-cost water gun.

Special tips from DIYhappy

  • Irrigation cannot be done for button batteries or vegetable  matter. The vegetable can expand and become very difficult for removal and button battery during ear irrigation can cause alkaline necrosis.
  • If not on a budget then consider as a doctor to have electric ear syringe which is becoming very popular among (ED) population.
  • You should know that irrigation is very safe for those who had never problems with the eardrum, Tympanic membrane. If the patient in the past had the perforation than the pressure should definitely not be exceeded.

Fun history fact

Ear Syringing is used already for circa 2,000 years. Almost the same technique is still used today by ear, nose and throat doctors. Looks like flushing out the ear with warm water is a good technique that works.

Can we irrigate our own ears with syringe procedure?

  • Yes, we can! If we are 100% sure that the eardrum is O.K.!
  • We also must be gentle while rinsing out ears with warm water.
  • The self-care procedure is more effective if we use a wax softener 15 minutes before we irrigate our own ears.


If the irrigation treatment with a Wax RX bulb syringe or an Elephant ear irrigator bottle (filled with warm water)- as described above does not help then the doctor may recommend medications for the wax removal. Ear drops can soften the wax which can be than removed with an ear endoscope, ear swab tool or other cleaning tools

Carbamide peroxide medications:

  • Earwax Removal Kit
  • Murine Ear Wax removal System

​Those ear drops are used only if the excessive ear wax cannot be treated the other way, because the ear drops can irritate the delicate skin of an eardrum and ear canal.

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