Micro suction ear wax removal is a safe method of removing ear wax even if the client has a perforated ear drum. This client warned me he has a large perforation before I started the procedure, which is why we ask the triage medical questions before the procedure starts, so I knew not to use a water treatment.
Once I had removed the wax with micro suction we were able to see clearly a very large perforation, which he had never seen before. It was caused by an aggressive syringe many years ago, this procedure is no longer used. The damage is so severe that the ossicles bones are visible and he has to be extremely careful never to get water in his ears.
However, we know the perforation has been there for many years and it looks clean and dry. I will see this client regularly now to keep the ear clear of wax going forward.
So do not worry if you have a perforation as you are still able to have the micro suction procedure. Even if you are unaware of the perforation this method does not touch the ear drum so it is still safe.