Clogged Ear

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍rightleftboth ear clogged sensation

Onset was ‍gradualsudden, started ‍whileafter ‍ ‍using a Q-tipsswimmingintroducing water into ear canal

Pattern ‍constantintermittent

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Associated symptoms: *Try using right-click for negatives*

‍hearing loss

‍ear pain

‍ear discharge

‍tinnitus

‍dizziness

‍vertigo

‍nasal congestion

‍rhinorrhea, ‍clearcolored

‍sore throat

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills



Contributing factors:

‍smokingpast smoking

‍flight travel

‍diving activities

‍swimming

no history of: ‍otitis externa, ‍eustachian tube dysfunction, ‍sinusitis, ‍allergic rhinitis, ‍upper respiratory infection

no use of: ‍nasal steroids, ‍oral antihistamines, ‍decongestants, ‍antibiotics drops





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Nose: ‍clear, discharge ‍clear, ‍

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍





ASSESSMENT:

‍Cerumen impaction ‍likelysuspectedpossible

DDx: cerumen impaction, Eustachian tube dysfunction, serous otitis media, acute otitis media, foreign body in the ear, otitis externa, acute hearing loss, temporomandibular joint disorder, sinusitis, allergic rhinitis, barotrauma, neoplasms of the ear canal or nasopharynx, neurological disorders affecting cranial nerves, cholesteatoma





PLAN:

Investigations:

- Audiogram

Treatments:

- Oil drops twice daily for 7 days

- Manual removal of cerumen

- Ear irrigation

- Avoidance of q-tips

Further care:

- 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