If a patient is suffering from contraindications like perforations, infections or mastoid cavities and has had a history of middle ear issues the best and safest method for ear wax removal is the endoscopic micro suction procedure.  The procedure is safe not least because the audiologist has a complete view of the ear canal using medical grade endoscopy to extract the wax gently with suction.  The old ear syringing method has been replaced as it allowed water to be irrigated in to the ear without the acuity or accuracy required to not cause damage to the delicate eardrum.