Foreign Body?

A healthy 30-year-old male presents to urgent care with concern for decreased hearing in his right ear. He says it seems like his hearing has been gradually getting worse for a few weeks. There is no pain, but a sensation of “fullness.” He has no history of ear trauma or infections. The following image of his right ear is obtained with a Wispr digital otoscope. What is the next step in management? The patient has an object in his ear canal. The object appears to be an almond, but there is no history from the patient to suggest this is the case. A curette was used to gently remove the object. The object was a piece of congealed cerumen (ear wax). This case is interesting because cerumen does not usually form a shape like this. Cerumen usually is diffusely organized and tends to layer inferiorly due to gravity. It can also take on a transparent appearance as this previous case shows. Cerumen is not a foreign object as it is a natural part of the body's defense mechanism. Examples of true foreign bodies include ants, ticks, flies, pinto beans, pencil tips, earbuds, and earrings. WiscMed has published a visual guide to common ear conditions. This guide can be found here.