Day Ear Knife — Granulation Scarification

Day Ear Knife — Granulation Scarification

The Day knife is the small-bladed angled-tip ear knife used for scarification of granulation tissue in the external auditory canal — typically chronic otitis externa with hyper-granulation, recurrent canal granulation polyps after grommet displacement, or the granulation overgrowth at a healed mastoidectomy cavity edge. The blade is sharp enough to cut granulation but short enough that the operator cannot inadvertently advance into the tympanic membrane.

Scarification rather than excision

Granulation tissue is highly vascular and excision produces persistent bleeding that is difficult to control in the office setting. Scarification — multiple superficial cuts that disrupt the granulation matrix without removing it — promotes natural fibrosis and granulation regression over 2-3 weeks, with minimal acute bleeding. Day’s technique was the cold-knife predecessor of the silver-nitrate-stick cauterisation that most modern outpatient ENT clinics now use for the same indication.

When silver nitrate is contraindicated

Patients with documented silver allergy and patients with a known tympanic-membrane perforation (where silver nitrate would burn the middle-ear mucosa) need the cold-knife alternative — the Day scarification approach remains the right tool for these specific cases.