Question 1

A patient reports symptoms of otalgia and difficulty hearing from one ear. The provider performs an otoscopic exam and notes a dark brown mass in the lower portion of the external canal blocking the patient's tympanic membrane. What is the initial action?

A) Ask the patient about previous problems with that ear.
B) Irrigate the canal with normal saline.
C) Prescribe a ceruminolytic agent for that ear.
D) Use a curette to attempt to dislodge the mass.

A

Accepted Answer

A

Question 2

A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The provider notes that the patient has dry skin in the ear canal. Which preparation is US Food and Drug Administration (FDA) approved for this use?

A) Carbamide peroxide
B) Hydrogen peroxide
C) Liquid docusate sodium
D) Mineral oil

A

Accepted Answer

Carbamide peroxide is FDA approved for use as a cerumenolytic and can effectively help to soften and remove excessive cerumen buildup. Additionally, it is less likely to irritate dry skin in the ear canal compared to hydrogen peroxide. Liquid docusate sodium and mineral oil are not FDA approved as cerumenolytics.

Question 3

A child has recurrent impaction of cerumen in both ears and the parent asks what can be done to help prevent this. What suggestion will the provider provide?&#10;A) Cleaning the outer ear and canal with a soft cloth&#10;B) Removing cerumen with a cotton-tipped swab&#10;C) Trying thermal-auricular therapy when needed&#10;D) Using an oral irrigation tool to remove cerumen

Accepted Answer

Cleaning the outer ear and canal with a soft cloth is the best suggestion as it is a safe and effective way to prevent cerumen impaction. Using a cotton-tipped swab can push the cerumen further into the ear canal and cause injury. Thermal-auricular therapy and oral irrigation tools may have some benefit, but they are not recommended for routine use and should only be used under the guidance of a healthcare provider.

Deck 63: Cerumen Impaction