In Germany, removing earwax is done in out-clinic ENT-patients daily and is associated with risks and complications. These should be identified using a systematic review. In comparison, an online-survey under out-clinic ENT surgeons should describe their everyday practice.A systematic search using PICO-questions in MedLine was analyzed following the PRISMA schema, supported by AI technologies. In addition, an online-survey under out-clinic ENT-surgeons about cleaning the external ear channel has been done.Finally, 13 studies of originally 1521 could be included. All conceivable complications occurred, most frequently injuries, inflammations, hearing loss, dizziness, and balance disorders, more rarely caused by ENT-physicians than by other persons. These results were supported by the results of the survey. Totally, two months were needed for searching and reporting.Using AI could accelerate the procedure of a systematic review significantly. Cleaning the External auditory canal more intensively than as part of everyday body care is impossible without any additional tools. Any other method has its risks and complication rate. In general, these could be differentiated and treated by ENT-physicians only, as demonstrated both by the literature and the results of the online survey.