IHS Cerumen Management

Question 1

Which of the following is an absolute contraindication for cerumen removal via irrigation in a hearing instrument specialist's scope of practice?

Accepted Answer

A perforated tympanic membrane

Answer

Dry, flaky cerumen

Answer

Mild conductive hearing loss

Answer

A narrow ear canal

Question 2

Before performing cerumen removal, a hearing instrument specialist should FIRST:

Accepted Answer

Perform an otoscopic inspection of the ear canal

Answer

Select the appropriate curette size

Answer

Soften the cerumen with mineral oil for 24 hours

Answer

Check the patient's audiogram

Question 3

Which type of cerumen is considered most difficult to remove and most likely to require referral to a physician?

Accepted Answer

Hard, impacted cerumen occluding the canal

Answer

Wet, honey-colored cerumen

Answer

Soft, recently deposited cerumen

Answer

Flaky, dry cerumen near the outer canal

Question 4

A patient presents with a completely occluded ear canal due to cerumen, but reports a history of ear surgery with a mastoid bowl. The most appropriate action is to:

Accepted Answer

Refer the patient to a physician

Answer

Proceed with irrigation using warm water

Answer

Use a curette to remove the wax mechanically

Answer

Apply ceruminolytic drops and recheck in one week

Question 5

Which of the following ceruminolytic (wax-softening) agents is generally considered safe for home use prior to cerumen removal?

Accepted Answer

Hydrogen peroxide 3% solution

Answer

Isopropyl alcohol 70%

Answer

Prescription-only enzymatic drops

Answer

Vinegar and water solution

Question 6

During otoscopic examination, the specialist notices the cerumen is dark green and has an unusual odor. The BEST course of action is to:

Accepted Answer

Refer the patient to a physician, suspecting infection

Answer

Proceed with standard mechanical removal

Answer

Irrigate the canal to clear the debris

Answer

Apply ceruminolytic drops and schedule a follow-up