Cerumen Impaction

Question 1

What is the typical history associated with cerumen impaction?

Answer 1

Hearing loss, ear fullness, and discomfort. History of using cotton swabs or hearing aids. Possible ear pain or tinnitus.

Question 2

What are the key physical examination findings in cerumen impaction?

Answer 2

Visible cerumen obstructing the ear canal. Possible redness or swelling of the ear canal. Tympanic membrane may be obscured.

Question 3

What investigations are necessary for diagnosing cerumen impaction?

Answer 3

Clinical diagnosis based on history and physical exam. No further investigations typically needed unless complications are suspected.

Question 4

What are the non-pharmacological management strategies for cerumen impaction?

Answer 4

Avoidance of cotton swabs and other objects in the ear. Use of ear drops to soften wax. Regular ear hygiene practices.

Question 5

What are the pharmacological management options for cerumen impaction?

Answer 5

Cerumenolytic agents (e.g., carbamide peroxide). Manual removal by irrigation, suction, or curettage. Analgesics for discomfort if needed.

Question 6

What are the red flags to look for in cerumen impaction patients?

Answer 6

Severe pain or discharge. Signs of infection: redness, swelling, fever. Persistent hearing loss despite wax removal.

Question 7

When should a patient with cerumen impaction be referred to a specialist?

Answer 7

Refractory or recurrent cerumen impaction not responding to standard treatment. Suspected underlying pathology (e.g., cholesteatoma). Need for specialized removal techniques.

Question 8

What is one key piece of pathophysiology related to cerumen impaction?

Answer 8

Accumulation of earwax causing blockage of the ear canal. Can result from overproduction or impaired clearance. Leads to hearing loss and discomfort.