Case study: shared with patient's consent
A 38-year-old male attended the clinic complaining of pain and a blocked sensation in his right ear. He did not have any history of ear infections or other issues, but swims regularly and wears custom-fitted swim plugs in the pool.
With video otoscopy, I showed the patient that his right ear was completely blocked with wax. This is common among people who use earplugs, earbuds and hearing aids on a daily basis. These objects interrupt the natural migration of wax out of the ear canal and can eventually create a complete blockage in the canal. Removing this type of wax blockage is pretty straightforward when done by a professional. In this patient's case, however, once the wax was removed it was clear that there was another problem.
I suspected this patient's ear pain was the result of an underlying outer ear infection, which would make sense in the context of his regular swimming. When the ear canal is blocked with wax, water can become trapped behind the wax, creating the perfect environment for an infection.
Fortunately, we had an in-house Ear, Nose and Throat (ENT) specialist consulting across the corridor, and I was able to get a specialist opinion immediately. The patient soon started a course of antibacterial ear drops and was feeling much better a week later when he saw the specialist for medical review. His eardrum was looking much healthier by that time and his symptoms had resolved.
Outer ear infections are a relatively common finding in our practice, and the close working relationship between audiology and ENT services at the Lindfield Specialist Centre has proved to be an effective and time-efficient solution for patients who have more than just earwax impaction.
Next case study: exostoses! Stay tuned...
