First I'll go through a few simple questions about your ears and related health. Then I'll thoroughly exam your ears; this involves checking both the outside and inside of your nears including the condition of the skin, eardrum, wax, blood supply - in fact everything that's visible! I will tell you exactly what I can see and what (if anything) needs doing. Often there will be wax present in the ear but the condition and position of the wax means that clearing it out is not absolutely necessary. If this is the case I will always let you know so you can decide whether to have it cleared then, or perhaps leave it a few months; my focus is on professionalism, not profit!

I'll ask you to sit on a therapy table (like a massage table but elevated so it's more like a reclining chair) I'll Illuminate your ear using a powerful head torch. I do not use a microscope for this procedure because it is not the safest way to perform micro-suction. A small funnel (a speculum) is held just inside your ear to make the canal easier to view. Then I'll insert a fine tube connected to the suction machine. The suction is controlled both on the machine and by my fingers to get the perfect setting for your ears. Because of the suction it can be a bit noisy, and you may find it feels a little cool because of the air being drawn in, but it is only for a short time and will not damage your hearing. There are a variety of noises as the suction machine draws on the wax; sometimes it's silent when the wax seals the suction tube, sometimes it pops when the wax suddenly shoots up the tube and sometimes it 'squeals' when skin or genetic dry wax vibrates in the tube. Throughout the procedure I will be telling you exactly what I'm doing, checking that you are comfortable and visually watching your face to make sure everything is just right for you.

The procedure can take anything from 5 minutes to 45 minutes (it's impossible to predict because of the many possible conditions the ear and wax may be in). Typically you will be in and out in under 20 minutes.

Many people find the whole procedure extremely relaxing. Very occasionally it can be uncomfortable due to the shape and size of the ear canal or the position of the wax, but this is not common. But it is noisy - as you can imagine having a vacuum cleaner in your ear is not going to be quiet! The noise can be controlled to some degree using various techniques. As a trained Paediatric Audiologist, I provide the quietest and most pain-free ear suctioning available.

Removal can be done by syringing - not recommended since very few people perform this procedure safely. The incidence of injury is still too high and now many clinics are shying away from it altogether. But syringing can be perfectly safe when it's being performed by a trained expert. By ear candling – an wholly ineffective technique that weakly draws in cold air and leaves a yellow staining from evaporation. Superficial burning is a significant risk. However, there are some psychological benefits to ear candling (but absolutely no physical benefits). By curettage (manually scooping out wax) – effective and safe only when performed by an expert.

Earwax is a natural thick substance created by special cells in the ear. It's made of skin cells, fats, alcohol and cholesterol. It plays an important part in keeping the ear canal clean and healthy; it traps dust and small objects (including insects), helps to sterilize the ear, lubricates the skin and even clears itself out of the ear! Sometimes this self-clearing mechanism fails, perhaps due to too much hair, too much dust/dirt, use of cotton buds or bony growths in the ear (like swimmer's ear).

Ears blocked with wax can affect your hearing, trap water in your ears (increasing the risk of infection), and cause pain and imbalance. Blocked ears can also hide a multitude of conditions that need medical attention - so have your ears checked and cleared by an expert.

Ear suctioning (micro-suction) is the most favoured method of wax removal because of its universal effectiveness and relative safety. Micro-suction involves drawing out wax through the use of a vacuum. There is NO need to use ear drops beforehand when micro-suction is used – if oil is needed then this will be done at the time of the procedure. Sometimes follow-up appointments are necessary for severe wax blockages. Micro-suction must be performed by a trained clinician. As an expert audiologist, I have been training staff and performing all methods of wax removal for 30 years, mostly in a hospital setting.