Patient will present as → a 25-year-old patient presents with unilateral hearing loss. Weber reveals lateralization to the right ear. Rinne test reveals the following: RIGHT: bone conduction = 10 seconds, air conduction = 5 seconds; LEFT: bone conduction = 5 seconds, air conduction = 10 seconds.
Cerumen impaction—buildup obstructs the auditory canal and is the most common cause of conductive hearing loss
- Cerumen may be pushed further into the ear canal and accumulate during patients' attempts to clean the ear canal with cotton swabs, resulting in obstruction or impaction
Cerumen impaction is best treated by irrigation after several days of softening with carbamide peroxide (Debrox) or triethanolamine (Cerumenex)
- Carbamide peroxide (Debrox) - apply 5 to 10 eardrops twice daily up to four days, keeping drops in the ear for several minutes by keeping the head tilted and placing cotton in the ear
- In patients with recurrent cerumen impaction and no significant ear disease - a cotton ball dipped in mineral oil and placed in the external canal once per week to help liquefy cerumen and aid the normal elimination mechanism
cerumen impaction in the right ear
effusion in the left ear
An effusion or otitis media could potentially cause a conductive hearing loss in the affected ear. The Weber test will lateralize to the left ear and bone conduction will be longer than air conduction in the left ear.
otitis media in the left ear
pain on palpation of tragus or mastoid area
Otitis externa and mastoiditis are not associated with hearing loss.