If you have confirmed soft ear wax, then you do not need to soften it as it is already soft. Also, if you have a perforated ear drum that has not healed, then you should not use ear drops before a microsuction procedure. In every other case, pre-softening the wax is recommended: in “Aural microsuction for wax impaction: survey of efficacy and patient perception“, a significant finding was “Patients who had used cerumenolytics [ear drops or sprays] reported significantly less pain and vertigo [dizziness]”. Taking into consideration this important information, we strongly recommend that patients should use 2 to 3 squirts of Earol spray (optionally with the addition of 3 glycerine drops 2 – 3 times a day) for at least 3 days prior to a microsuction procedure. Very hard impacted ear wax can also be softened with Waxsol used for two days prior to a microsuction procedure.
It is worth noting that there has been a recent review of various studies comparing the effectiveness of different types of ear drops. The conclusion is that no one brand of ear drop has been comprehensively shown to be better than any other. Nevertheless, we still recommend the use of Earol spray with the optional addition of glycerine drops as this has been shown to increase the comfort as well as reduce the chances of vertigo during a microsuction procedure.
We specifically recommend you do not use sodium bicarbonate or hydrogen peroxide ear drops: In a study called “Suction-generated noise levels during aural toilet“, noise levels were measured in the ear of an artificial model head using various suction tubes on different substances. It was noted that the suctioning of water generated very high levels of noise (over 130 dB(A)). For this reason we do not generally recommend the use of aggressive ear drops that contain sodium bicarbonate or urea hydrogen peroxide as it can make ear wax very watery, greatly increasing the noise level during the procedure. In addition, prolonged use of sodium bicarbonate ear drops can lead to an opportunistic infection of the ear canal (because sodium bicarbonate reduces the protective acidity level within the canal); and prolonged use of urea hydrogen peroxide drops can cause severe irritation to the skin surface in the ear canal in some people (hydrogen peroxide is bleach, after all).