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Treating a wax blockage with hydrogen peroxide in an adult ear with open ear tubes
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mmmeyers posted:
Hi! I am an adult who went to an ENT last month and was told that I had fluid in my middle ear. Three weeks ago, I had a myringotomy and a tube inserted in that one ear. My hearing instantly improved, and I didn't think that I had any complications from the procedure. When I had my appointment yesterday, however, I was told that there was a blockage (I think mostly earwax), and that I should put 2 to 4 drops of peroxide in my tubed ear once a day, every day to clear that blockage. Unfortunately, my doctor ran off before I got a chance to ask him more questions.

I'm really scared to follow my doctor's directions. I did buy a bottle of topical 3% hydrogen peroxide, but I haven't used it yet. I've looked online, and many doctors are adamant about never putting 3% hydrogen peroxide in an ear with OPEN tubes (As an example, from this page: 'Some of the ear drops that you may have used prior to the operation may be harmful to the ear and may cause significant pain...Do not place any ear drops in the ear that contain alcohol, hydrogen peroxide, oil, etc.') (or here : 'Do not insert peroxide into the ears or irrigate the ears if you have ear tubes, if the eardrums are not intact or if discharge is draining from the ears.'). My doctor's instructions were to take an eyedropper, put 2 to 4 drops of 3% hydrogen peroxide in my ear so that it gets down to the clog IN the (open) tube, jiggle the earlobe around a bit so that it really gets in there, and then put a cotton ball in the ear to keep it in. I was told to do this once a day, every day, but I was not told for how many days. I was not told to dilute the hydrogen peroxide, and I was told it was safe to do this. Finally, I was told that if this doesn't clear the blockage, I will have to have my tube removed, have the blockage cleared, and have another tube put in... in three weeks. I would prefer to not have a further procedure.

When I Googled for more information about 'ear tubes' and 'hydrogen peroxide,' I got mixed opinions about whether hydrogen peroxide should be used with open tubes. What I want to know is:
1) Should I follow my doctor's advice and use the hydrogen peroxide? Once again, I am an adult (not a child) with an open ear tube that has a blockage. If I should follow my doctor's directions, should I do it exactly as per my doctor's instructions (above)?
2) If the answer is yes, will using the peroxide hurt (not tickle or fizz, but actually hurt) or cause any kind of damage to the eardrum? What I've read is basically peroxide use is fine UNLESS you have open tubes. Then it will be terribly painful and possibly damaging to the eardrum. Is this true?
3) I was not told a duration for using the peroxide. I was only told to use do the 2-4 drops once a day, every day. Should I continue to use it once a day until my next appointment in three weeks? Or should I only do it for one week? (In the few forums where mothers say that their doctors instructed them to use peroxide in their child's ears that have open tubes, it seems that most were told to use the peroxide for one week.)

Thank you in advance for any input!
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Rod Moser, PA, PhD responded:
For my own patients, I do not recommend the use of peroxide, in any age, or in any dilution, in a person with tubes. With that said, I do not know if your ENT has safely done this with his patients and had success. Personally, I do not know any effective, non-surgical way of clearing a clogged PET (pressure equalization tube). Peroxide does have the potential of causing some tissue destruction in the sensitive middle ear, should some make it in there, but since your tubes may be completely occluded, it may not do any harm. Again, I am only blindly guessing, since I have no way of seeing your ear first-hand.

The Internet is filled with conflicting information, and medical providers are famous for making their own rules and develop their own treatment methods, even though they may differ from mainstream methods.

I cannot tell you not to follow your doctor's instructions, I can only offer my opinion or share what I do with my own patients. Since your doctor's instructions were vague anyway, calling him for both clarification and justification (based on what you have read) is in order.
 
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mmmeyers replied to Rod Moser, PA, PhD's response:
Thank you for your quick response, doctor! I apologize for not responding to you sooner. In the end, I did follow my doctor's instructions, though I still question its validity. My hearing is crisper since I used the peroxide, so I do believe that it helped in clearing the blockage at least somewhat, however, the intense burning sensation I experienced makes me worry about damaging the area.

Can I ask you a follow-up question? Unfortunately, my doctor's office doesn't seem to have the time to respond to my concerns, and I'm not sure where else to turn. I have had excess ear wax issues since I was a kid; every time I had the problem, it would clear up on its own or through a few rounds of Debrox use. Having fluid in the ear and having to undergo a myringotomy and insertion of tubes is a new experience for me. My question is: How is it possible to prevent ear wax blockages from developing within the tubes? As I've said, I have an inclination toward excess ear wax. I believe that this latest blockage developed just days before my doctor's appointment; I knew that my ear felt waxy and that my hearing wasn't quite as sharp as it had been after the procedure. I believe that I have succeeded in clearing out the blockage, but I have two weeks until my next appointment (which was also how long I had between the operation and the first post-op check-up). I figure, due to my history, that another blockage is imminent before that appointment. I'm afraid that I'll develop another ear wax blockage between now and that appointment. I don't understand. Do people really get these tubes put in and never have any ear wax clog them up? How is that possible? And, if so, how can I prevent it from happening to me over and over again? Is my doctor going to have to remove the tube every month or so, suction out the small amount of wax, and re-tube it? Or should I just have him remove the tube and see what happens?
 
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Rod Moser, PA, PhD replied to mmmeyers's response:
The amount and consistency of earwax that a person makes is really genetically determined....just one more thing you can blame on your parents (or grandparents). There are NO medicines that can keep these modified wax-secreting pores from over-producing. So, it is not the tubes that are causing excess wax, it is you. Sorry.

As I mentioned, I am not a personal fan of peroxide in anyone with tubes, but it seems you did okay. Short of having your doctor clean it out (with suction and magnification) on a regular basis, there is really nothing you can safely do at home. Your doctor does not have to remove your tubes to clean your ear canal.
 
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mmmeyers replied to Rod Moser, PA, PhD's response:
Ha, okay, I understand now! I did survive the peroxide unscathed (I think), but I can see why it's not recommended. I do believe that it was effective in clearing out the blockage, but I doubt that will remain clear for that long.

Huh, okay, my doctor did say that he would have to remove the tubes to clear the blockage and put a new tube in if the peroxide didn't work. I'll have to ask him why he can't clean the blockage without removing the tubes. Unfortunately, he isn't forthcoming with a lot of information and seems unwilling to spend time answering questions. That's my own battle, though!

Thank you so much for answering my questions and making this entire process and experience much clearer to me! You are doing this community a wonderful service! I only have one follow-up question, but it's very minor. I'm going to be traveling in a mountainous area where my ears have always felt a lot of pressure and would pop (long before I got the tube). Can this cause any kind of damage to the tubed ear or the eardrum? Is there any reason to avoid high altitudes?
 
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Rod Moser, PA, PhD replied to mmmeyers's response:
Clarification: Your doctor can clean the EAR CANAL (of wax) without removing the tubes, but he cannot clean out a clogger ear TUBE (with wax). Clogged pressure-equalization tubes would need to be replaced.

At this point, I do not see any harm for you to travel to or from higher altitudes. You will most likely be fine.
 
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mmmeyers replied to Rod Moser, PA, PhD's response:
Okay, I understand now! Thank you for the clarification! I'm all ready for my appointment now. Thank you again: I feel much more at ease being armed with a bit of information beforehand!


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