This is the most straightforward method of wax removal.
This is carried out using the loupe and either a Jobson Horn (miniature scoop) and/or fine calipers to capture the wax and gently remove it. Sometimes it just helps to physically lift the piece of wax if it is quite solid and deep, as the irrigation method cannot shoot the water behind it, and the microsuction cannot get hold of the wax as it is too dry. Quite often we will refer to putting in more oil, however in some instances, the wax is so dry it can come away from the wall of the ear canal itself and be gently pulled out with forceps.
This would usually be used in minor cases, with soft wax. For cases of impacted or hard wax, the wax would require softening over a few days with drops beforehand.
Manual removal is preferred if your ear canal is narrow, the eardrum has a perforation or tube, other methods have failed, or if you have diabetes or a weakened immune system. This method is also preferred if you suffer from Tinnitus as there is no noise whist the procedure is carried out.