Q. Can we use hydrogen peroxide to clear wax in patient undergone mastoidectomies?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Oct 03, 2019

Hello doctor,

My 84-year old stepfather had, apparently, two radical left-ear wall-up mastoidectomies in the late 50s and 60s. The second was done to fix the poor job done by the first at a county hospital for the indigent. Recently, caregivers said they were planing on using hydrogen peroxide in his left ear to clear much wax buildup. I learned of these surgeries from my step dad and from reviewing some ancient medical records. As his POA, I need to know of any dangers possible if hydrogen peroxide is administered in such an ear canal that, I understand, is permeable, and leads into his mastoid chamber.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)


Welcome to icliniq.com.

As I understand, your father had undergone two ear surgeries when he was in his 30s or so. He would have either undergone canal wall up or canal wall down mastoidectomies. Radical and modified radical come under CWD, and cortical comes under CWU mastoidectomies. Anyways, hydrogen peroxide can be applied in his ear for wax removal if,

1. The ear has been disease-free for many months now, implying, there has been no ear discharge of pus or liquid.

2. No ear perforation, which would have presented with discharge and pain.

3. No raw area in the ear canal.

The posterior canal is not permeable. In a wall down surgery after removing the wall, we close the defect with autologous cartilage or some material. Probably in his days, they may have left the cavity open. In either case, it gets lined by the skin, and that will be the case in your father also unless he has any disease or perforation.

It is okay to use hydrogen peroxide to clear the wax if it does not come out using probe and otoscope or an endoscope. If an endoscope is put in the ear and under endoscope guidance wax be removed, then that is the best and safest. I hope I have answered your query. Revert to me in case you want any clarification.

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