SYMPTOMS: Ear Wax, a green Circle, and Small Ear Canals

Symptoms of Ear Wax

Donna, 52 had difficulty hearing Speech in a noisy room, especially women’s speech, and wanted her hearing aid turned up.  Adjusting a hearing aid is easy with the necessary software and should make an improvement, but you need to make sure the ear canal is clear.  The first rule of intervention is “Do no harm”.

Donna had been wearing hearing aids for years, and was hearing well when initially fit.  Using an otoscope to look into her ears to ensure excessive wax build up was not the problem.  She has small ear canals, limiting the ability to see the canal and to view the eardrum from different angles.  Initial inspection of the right ear showed a green circle surrounded by earwax.  What is the green circle in her right ear, and should it be cleaned?  A clearer view of Donna’s ear reveals why her ear should not be cleaned.  This raises other questions for hearing aid dispensers:

  • Is there anything I can do to help?
  • How long should the tube stay in the ear?
  • How long after the tube is inserted can the client wear a hearing aid?
  • What should be done if there is drainage in the outer ear?
  • How often does the patient need to follow up with and ENT?
  • How can a hearing aid dispenser help by counseling the client to follow the doctor’s recommendation’s and keep water out of the ear? How long the tube stays in the ear is dependent on the ears health.  The ear returns to normal quickly in some cases.  The tube will be removed once the ear is healthy, although in some cases they can remain permanent.
  • When can you resume wearing a hearing aid?  The goal is resuming wearing the hearing aid as soon as possible.  The tube is allowing fluid to drain from the middle ear to the outer ear.  If drainage stops the wear of a hearing aid should be resumed.  This should only happen if after the follow up with the ENT gives them clearance to wear.  One note of caution, if you have a tube inserted do not use cotton swabs to clean the ear.


Hearing Journal May 2012 Through the Otoscope by Michael J. Rensink, MD