Although ear microsuction is usually our preferred method of earwax removal, we have been using the Bionix OtoClear SprayWash irrigation technique at Liverpool Hearing Centre for over a decade now. It's a perfect alternative technique when you need to switch over from microsuction quickly. As experienced earcare clinicians, you want your speed of action to match your speed of clinical judgement, and the Bionix SprayWash kit allows for exactly that.

PRICE UPDATE: Due to supplier cost increases, prices for the Bionix OtoClear SprayWash Kit will increase effective April 1st, 2025. Order now to secure current pricing while our limited stock lasts.

In our opinion, water methods should be avoided when possible. They can introduce infection or at least provide a conduit; you can't see what's happening in the canal, the warmth of the water can bring the blood to the surface and immediate immersion after removing moulds and hearing aids is rarely advised.

Also, any method of irrigation and syringing is contraindicated for patients whose eardrum may be perforated, where grommet tubes are present or suspected, or an active infection is present or suspected.

Any contraindications should be spotted through the use of an effective questionnaire and consent form. We have a digital one for free here designed for use on smartphones and tablets.

So there are lots of good reasons not to but there are times when it does become good clinical judgement to put the suction tube down and turn to the trusty irrigator. The main reasons are as follows:

• The earwax is beyond the second bend of the canal. Airflow noise for the patient increases significantly the closer you get to the eardrum with the suction tube and the risks of tinnitus and hearing loss will likely increase. Read our blog where we measured the noise at different depths of the ear canal using the Lateral Air Hook suction tube (our most powerful suction tube)
  
  
• The earwax is extremely viscous. This can be naturally occurring but the prevalence increases in patients who have been using earwax softeners such as olive oil, hydrogen peroxide and sodium bicarbonate. Often there can be a thin coating all around the canal walls and tympanic membrane that makes it difficult for the practitioner to get their bearing to safely microsuction.

We sell the gentle ph-balanced hydrogen peroxide Cl-ear Express Ear Spray (case of 5) and 2 brands of olive oil sprays.

1. Fluid will not directly impact the eardrum - At the tip there are three holes, which direct the fluid towards the ear canal walls, virtually eliminating the risk of damage to the eardrum.
   
   
2. The OtoClear Tip does not occlude the ear canal - It has special exit portals through which effluent is discharged from the ear canal. This prevents a potential build-up of pressure in the ear canal.
   
   
3. The tips cannot be over-inserted - The unique flared design of the OtoClear Tip ensures that it cannot be over-inserted in the ear.
   
   
4. The pressure is extremely controllable using a gentle action on the squeeze handle. A gentle, turbulent flow is usually enough for the removal of loose or liquid wax. Stubborn hard wax is often best removed with microsuction or with a dry tool instrument such as a Jobson horn or a cerumen hook.

The number one main reason is simply convenience. You can make the switch from ear microsuction to water irrigation in a minute.

Also, the exit portals of the OtoClear Tip are designed to direct drainage into the ear basin, reducing cleanup time. This design also reduces splashback onto the operator.

Since implementing the Bionix OtoClear SprayWash Kit in 2013 at Liverpool Hearing Centre, it has become an indispensable tool in our clinical practice. We would never run an earwax removal clinic without it, even though we also have Guardian and Propulse irrigators available.

What makes the Bionix system stand out after a decade of use:

• Always ready: No setup time required
• Portable: Easy to move between treatment rooms
• Simple cleaning: Quick to sanitise between patients
• Versatile: Effective on various types of earwax
• Patient comfort: Gentle yet effective removal
• Professional control: Precise water pressure management

We also have and use electronic pulse irrigator at Liverpool Hearing Centre, however, Bionix SprayWash is used far more often (daily) to mainly finish off the final third of the canal in a quick, gentle and safe way.

This review is based on over 10 years of clinical experience using the Bionix OtoClear SprayWash Kit at Liverpool Hearing Centre. The Hearing Lab Store is an authorised distributor of Bionix products.

The Hearing Lab Store offers a wide range of other services and products designed to support your clinical practice. Explore our Store for more products, explore our ready made microsuction equipment packages to find what's best for your needs, or consider our Microsuction Training and Tinnitus Training programs to enhance your skills. We also provide free digital forms in our Tinnitus Tool Kit, a Find a Locum Service, and Free Online Earwax Removal Patient Consent Forms.