From the Guidelines
No, you should not water flush an ear with a chronic hole in it, as it can lead to infection, pain, or ototoxic hearing loss, and instead, mechanical removal of cerumen is the preferred technique when the ear drum is not intact. According to the clinical practice guideline on cerumen impaction 1, the presence of a nonintact tympanic membrane, such as a perforated tympanic membrane or patent tympanostomy tube, limits the options available for cerumen removal and requires specialized equipment and procedures to safely remove cerumen without undue risk. Some key points to consider when dealing with a chronic hole in the ear include:
- The risk of infection, pain, or ototoxic hearing loss associated with irrigation in the presence of a perforated tympanic membrane 1
- The potential for caloric effects resulting in vertigo when using irrigation with a perforated tympanic membrane 1
- The importance of keeping the ear dry and clean, and consulting with a healthcare provider for recommended cleaning solutions and techniques, such as alcohol-based ear drops or hydrogen peroxide solutions specifically designed for perforated eardrums
- The use of protective measures, such as cotton balls coated with petroleum jelly or earplugs, when washing hair or engaging in activities that may expose the ear to water, to prevent water from entering the middle ear and reducing the risk of infection.
From the Research
Water Flushing an Ear with a Chronic Hole
- There is no direct evidence in the provided studies regarding the safety or efficacy of water flushing an ear with a chronic hole.
- However, the studies suggest that topical antibiotics can be effective in treating chronic suppurative otitis media (CSOM) and acute otitis media with otorrhea through tympanostomy tubes 2, 3, 4, 5, 6.
- The use of topical antibiotics, such as ciprofloxacin and ofloxacin, has been shown to be effective in resolving ear discharge and improving symptoms in patients with CSOM and acute otitis media with otorrhea 2, 3, 4, 6.
- Some studies also suggest that topical antibiotics may be more effective than systemic antibiotics in achieving resolution of ear discharge 2, 6.
- However, it is essential to note that the studies do not provide information on the use of water flushing as a treatment for ears with chronic holes, and it is unclear whether this method would be safe or effective.
Considerations for Ear Care
- The studies emphasize the importance of proper ear care, including aural toileting, in managing CSOM and acute otitis media with otorrhea 2, 3, 4, 5, 6.
- The use of topical antibiotics, either alone or in combination with other treatments, may be beneficial in resolving ear discharge and improving symptoms.
- However, the decision to use any treatment, including water flushing, should be made under the guidance of a healthcare professional, taking into account the individual's specific condition and medical history.