Hello, Ideally, the ENT should give wax dissolving ear drops to soften the wax then the procedure of micro suction (vacuum) for removal of ear wax should be done for the best effect, so that post-procedure the temporary change in hearing or mild ringing in the ears, should settle down after a few days. Since it is over a month in your case and you are having severe tinnitus, it is concerning. The loud noise from a vacuum device used during ear wax removal sometimes temporarily worsen tinnitus. Since it is not resolving on its own, you are advised to get clinically examined by an Audiologist as the noise might cause a temporary threshold shift, where hearing is slightly reduced for a short period. You are advised to get a second opinion from a different ENT, get evaluated about any damage to the ear drum (tympanic membrane). Hearing can reduce even if there is a partial perforation in the tympanic membrane (eardrum). The size and location of the perforation decides the extent of hearing loss. While smaller perforations cause minimal hearing loss, larger ones can lead to more significant hearing impairment. In case the tiny bones (ossicles) behind the eardrum are affected, the hearing loss can be more severe. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K. General & Family Physician