What are the potential complications of earwax removal procedures that I should inform my patients about?

Potential complications of earwax removal procedures include failure of wax removal, otitis externa, perforation of the tympanic membrane, damage to the external auditory meatus, pain, vertigo, otitis media due to water entering the middle ear when there is a previous perforation, exacerbation of pre-existing tinnitus, serious injury to the middle and inner ear (rare), bleeding (usually self-limiting), nausea, vomiting, and vertigo from temperature variations of the irrigating fluid ¹.