Name of the Procedure:

Common name: Ear wax removal
Technical/medical term: Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing (HCPCS code: G0268)

Summary

Removal of impacted cerumen is a medical procedure where a physician removes earwax that has accumulated and hardened to a degree that it blocks the ear canal and might affect hearing. This might be done on the same day as other hearing tests to ensure there are no blockages that could affect test results.

Purpose

Medical Conditions or Problems It Addresses:

• Impacted earwax causing discomfort
• Hearing loss due to earwax blockage
• Tinnitus (ringing in the ears)
• Ear infections or irritation ##### Goals or Expected Outcomes:
• Clear the ear canal to improve hearing
• Relieve symptoms like discomfort or ringing in the ears
• Prevent ear infections or complications caused by blocked earwax

Indications

Symptoms or Conditions:

• Earache or ear discomfort
• Hearing loss or difficulty hearing
• Feeling of fullness in the ear
• Tinnitus (ringing in the ears)
• Dizziness or balance issues ##### Patient Criteria:
• Presence of visible, impacted earwax
• Symptoms interfering with quality of life or daily activities
• Need for audiologic function testing where earwax could interfere with results

Preparation

Pre-procedure Instructions:

• No specific fasting is generally required.
• Patients may be advised to avoid inserting any objects or liquid into the ears prior to the procedure. ##### Diagnostic Tests or Assessments:
• Physical examination of the ear canal.
• Audiologic tests to assess the impact of the earwax on hearing, if applicable.

Procedure Description

Step-by-Step Explanation:

1. Patient is seated comfortably.
2. The physician uses a specialized otoscope to examine the ear canal.
3. A small suction device, curette, or irrigation system may be used to gently remove the wax.
4. Both ears are examined and treated if needed. ##### Tools, Equipment, or Technology:
   • Otoscope
   • Suction device
   • Curette (a small surgical instrument)
   • Irrigation system ##### Anesthesia or Sedation:
   • Typically, no anesthesia or sedation is required.

Duration

The procedure usually takes about 15-30 minutes.

Setting

Performed in a healthcare setting such as a physician's office, outpatient clinic, or audiology center.

Personnel

• Physician (usually a Primary Care Physician, ENT specialist, or Audiologist)
• Medical assistant or nurse (for support and documentation)

Risks and Complications

Common Risks:

• Mild discomfort during the procedure
• Temporary dizziness or imbalance ##### Rare Risks:
• Damage to the ear canal or eardrum
• Infection ##### Management:
• Instructions on what to do if discomfort or symptoms persist
• Antibiotics or follow-up visits if infection or damage occurs

Benefits

Expected Benefits:

• Immediate relief from symptoms associated with impacted earwax
• Improved hearing
• Enhanced results from audiologic function tests ##### Realization:
• Benefits are typically realized immediately following the procedure.

Recovery

Post-procedure Care:

• Mild discomfort may be managed with over-the-counter pain relievers.
• Avoid inserting anything into the ears post-procedure. ##### Expected Recovery Time:
• Usually minimal recovery time needed, with patients resuming normal activities shortly after. ##### Follow-Up:
• Instructions for follow-up visits if symptoms persist or complications arise.

Alternatives

Other Treatment Options:

• Over-the-counter ear drops to soften wax
• Home irrigation kits ##### Pros and Cons:
• Over-the-counter treatments can be less invasive but may be less effective and slower.
• Home treatments carry the risk of injury if not done correctly.

Patient Experience

During the Procedure:

• Mild discomfort or tickling sensation in the ear.
• Minor sounds from suction devices or irrigation systems. ##### After the Procedure:
• Some immediate relief and clearer hearing.
• Possible minor dizziness which usually subsides quickly. ##### Pain Management and Comfort Measures:
• Over-the-counter pain relief if necessary.
• Gentle, careful approach by the physician to minimize discomfort.