Cerumen Impaction

HISTORY:

‍RightLeftBilateral clogged ear for ‍ ‍hoursdays

Onset: ‍gradualsudden, following ‍ ‍using a Q-tipsswimmingintroducing water into ear canal

Pattern: ‍constantintermittent

Worsening factors: ‍none

Treatments tried: ‍none, ‍effectiveineffective

‍hearing loss

‍ear pain

‍ear discharge

‍tinnitus

‍dizziness

‍vertigo

‍nasal congestion

‍rhinorrhea, ‍clearcolored

‍sore throat

‍cough, ‍non-productiveproductive

‍sputum, ‍clearcolored

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills



EXAM:

General appearance: ‍well-appearing

Ears: -R: ‍normal, -L: ‍normal

Nose: ‍normal

Throat: ‍normalrednessexudate

Neck: ‍normallymphadenopathy



ASSESSMENT:

‍Cerumen impaction ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Audiogram

- Oil drops twice daily for 7 days

- Manual removal of cerumen

- Ear irrigation

- Avoidance of q-tips

- Referral to otolaryngologist

- Follow-up in ‍ ‍weeksmonths

- Return if symptoms worsen or if new symptoms develop such as hearing loss, dizziness, or discharge from the ear