BOPDHB Referral Guidelines for acceptance by ENT Clinical Nurse Specialist for ear wax removal (approved by the ENT department BOPDHB May 2013).

Initially referrals must have relevant information as to why aural wax needs to be removed.

Acceptance of referral is based on the following:

• The patient has no means to pay for a private nurse provider and canals obstructed with wax. That is for both children and adults.
• The case is a special needs - child or adult.
• Severe wax impaction noted on aural examination by GP to the point where significant discomfort/pain is felt.
• Suspected ear disease based on clinical history with associated otalgia but unable to view tympanic membranes due to wax obstruction.
• Failed or unable to do aural toilet for a valid reason.

War pension clients are generally funded for this service.

ACC clients with ACC funded hearing aids are automatically funded privately for wax removal.

There are RN's available in private at both Whakatane and Tauranga for wax removal using Otomicroscopy.