Rolled tissue or toilet paper is too fat and can't be put far enough into the ear.

Rolled tissue or toilet paper is too fat and can't
be put far enough into the ear.

Tissue spearing also won't work if it is not done often enough.
More pus gets into the middle ear in just a few hours.
You need to do tissue spears 4 times a day to begin with.

Tissue spear

You need to explain to carers why tissue spears are
so important, how to do it, and remember to tell them
they are doing a great job!