This wry-witted 87 year old female patient [listing her occupation on the intake form as 'domestic engineer'], known to the practice for three years, was seen for a periodic follow-up evaluation. She had been wearing CLASS III ITE hearings aids binaurally with recently noted reduced effectiveness on AD. VO examination revealed a +3 cerumen accumulation in the affected ear. With the referring PCP's approval, an ENT referral was made for cerumenectomy. Because of the deep canal cerumenous impaction and friable canal epithelium, curettage extraction was effective but resulted in a sizeable hematoma on the deep anterior canal wall [inline image below (19k)]. Audiological re-evaluation verified restored effectiveness of the AD fitting.

In consultation with the referred ENT, as the SOL was significantly medial to termination of the ITE canal segment and free of pain, discontinuance of hearing aid use was not recommended. A follow-up visit in one month revealed a virtually complete resolution of the hematoma [inline image below (18k)].