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Cerumen Impaction Pocket Guideline

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6 Treatment Figure 4. Management Algorithm Primary complaint by patient of cerumen Explain proper ear hygiene Otoscopy shows accumulation of cerumen? NO Hearing aid user END KAS1 YES Is cerumen associated with symptoms? * KAS2A Cerumen seen on routine office examination NO KAS2A YES Diagnose impacted cerumen KAS2B KAS3C See full text for specific considerations Treat with cerumenolytic agents, irrigation, or manual removal Retreat and consider dlternate diagnoses KAS9 Post- treatment otoscopy shows resolution? KAS9 Document resolution Education on control measures Successful resolution? Refer to specialist for further treatment KAS10 KAS11 END END YES NO YES NO NO NO NO NO YES KAS5A YES Does clinician consider the amount of cerumen significant? Does patient have any modifying factors? ** Patient has limited expressive language *** YES Cerumen prevents needed assessment of the ear?

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