In your ear
Barbara Lally was 14 when she lost her hearing. It happened without warning - she was doing a spelling test at school when suddenly she couldn't hear a word the teacher was saying. "I didn't know what had happened. I was terrified," she says.
It's a moment that has stuck in Ms Lally's mind, and although her childhood hearing loss was quickly diagnosed as being caused by a build-up of earwax, the 48-year-old retired teacher now has 15 per cent hearing loss, partly due to scarring from the multitude of ear infections and abscesses she has suffered.
Most of us have little reason to give earwax a second thought; it's simply something we remove with a flannel - or cotton bud (a habit to be discouraged, see box). But it does have a function - think of it as a sticky anti-fly strip, trapping all the bacteria and micro-debris that find their way into our ears.
But for some people, Ms Lally included, earwax can become a permanent problem, for reasons specialists are unable to explain. And her loss of hearing became a bigger burden when she became a teacher in 1982.
Before taking early retirement last year from Chapel Street primary school in Levenshulme, Manchester, Ms Lally had faced several awkward situations. "I was once taking the school's assembly when my hearing suddenly went - just as it had done when I was 14. Fortunately, primary children are good at understanding such situations. If they had been older it might have been more difficult."
At times she struggled in the classroom, too. "Some children have quiet voices, and the general level of classroom noise means voices can disappear into the ceilings and walls. When my hearing was suffering, I just had to walk up to whoever was speaking and explain that I was having a bad hearing day."
Yet, as Barbara Lally knows only too well, treatments to get rid of chronic earwax problems remain elusive. She has tried all the conventional therapies - antibiotics, eardrops, oils and syringing - but says they bring only short-term relief.
So when her GP decided it was unwise to continue with syringing, she decided to try an alternative - auricular thermotherapy, otherwise known as candling. Historically used by the Hopi Indians of Arizona, in the United States, to drive out spirits from the body as well as for medicinal purposes, candling involves inserting a specialy crafted tube of linen, impregnated with wax and herbs such as St John's wort, camomile and sage, into a patient's ear. The tube is then set alight and allowed to burn for 15 minutes, until about three inches remain. The burning creates a vacuum, sucking up any wax into the cone.
Although candling is a recognised treatment in parts of continental Europe, the UK medical establishment regards it with, at best, suspicion and, at worst, disdain.
Jeremy Sharpe, an ear, nose and throat consultant at Derbyshire Royal Infirmary, calls it "a lot of baloney". He admits he's never seen the therapy in action, but says: "Putting anything burning near the ear is not to be recommended, and the treatment has not been scientifically tested. It seems slightly suspect to say the least. I would not have it done to me."
Such criticisms anger complementary therapists such as Chris Carlisle, who runs a clinic in Wilmslow, Cheshire. Ms Carlisle, who treated Barbara Lally, claims candling helps not only excessive earwax and tinnitus (a constant noise in the ear), but also snoring, vertigo, ear eczema, glue ear, sinusitis and migraine. She says doctors should see the treatment for themselves. "It has been around for thousands of years, and would not have been used for all that time if it did not bring benefits."
Ms Carlisle says the flame never gets close to the ear, which is protected by the therapist's hand. "I would not practise auricular thermotherapy if I thought there was any danger. I believe syringing can cause pain - this is not the case with candling. I would love to have the opportunity to work with an ENT doctor or a GP and to do a before-and-after assessment. Maybe this would change the minds of some of those working in conventional medicine," she says.
Barbara Lally is adamant that candling has worked for her. "It was totally painless. And the benefits were immediate - unlike eardrops, where relief may take a few days or even a week. It was a much more pleasant way of being treated," she says.
Hear and how * At its worst, earwax can cause hearing loss, pain and coughs (the ear canal shares nerves with the throat). Even a small amount of wax can reduce the eardrum's ability to conduct sound.
* Earwax is usually treated with hydrogen peroxide solutions, or almond or olive oils. In accordance with the saying "never stick anything in your ears smaller than your elbow" the use of cotton buds is not recommended as it risks compacting the wax and causing damage to the eardrum.
* ENT doctors usually remove wax by syringe suction or curette techniques with the help of an operating microscope.