The patient is a 48 year old female who reports a slight decrease in hearing over the weekend in her right ear. She could not hear soft sounds like her fingers rubbing together next to her right ear, and using the phone on that ear was more difficult. She has aural fullness in that ear, no otalgia. She does not have any respiratory infections. She suspects wax accumulation, as she had been wearing insert style hearing protectors. She self treated with cerumenolytic drops. She found the ran out of her ear, so she inserted an earplug in the ear to keep the drops in. This then caused a substantial drop in the hearing thresholds.
Otoscopic inspection revealed cerumen accumulation.
The 226 Hz tympanogram is shown below.
- -Is the tympanogram consistent with cerumen obstruction or is it more consistent with middle ear infection?
