7
Figure 4. Footnotes
* Symptoms of Cerumen Impaction:
• Otalgia
• Tinnitus
• Ear Fullness
• Ear Pain
• Hearing Loss
• Vertigo
• Cough
• Hearing Aid Feedback or Malfunction
• Itching
** Modifying Factors:
• Anticoagulants
• Immunocompromised State
• Diabetes Mellitus
• Prior Radiation to Head and Neck
• Ear Canal Stenosis
• Exostosis
• Non-Intact Tympanic Membrane
*** Limited Expressive Language:
• Young Child
• Cognitively Impaired Adult