Numerous complications can result from the removal of cerumen from the EAC.2,3,4,7,9,12,13,19,20 The complication rate for irrigation is 1 per 1000 cases.2,4,7 It is higher for all other techniques. Irrigation can push cerumen further into the EAC. Irrigation fluid must be body temperature or slightly warmer. Cold fluid can cause caloric stimulation resulting in vertigo, vomiting, bradycardia, or syncope. Middle ear debris can be forced through a preexisting or iatrogenic TM defect, resulting in an otitis media, ossicle damage, labyrinthitis, mastoiditis, loss of hearing and balance, or a central nervous system infection. Otitis externa can result from abrasions to the EAC or retained fluids. Butterfly tubing is less likely than an angiocatheter to damage the EAC or TM because of its more pliable nature, larger diameter, and curved tip.