A 72-year-old man has reduced hearing and fullness in the right ear. Otoscopy shows obstructing cerumen, and the tympanic membrane cannot be

Question

A 72-year-old man has reduced hearing and fullness in the right ear. Otoscopy shows obstructing cerumen, and the tympanic membrane cannot be visualized. He has no ear pain, fever, diabetes, or tympanostomy tube. Which of the following is the most appropriate next step in management?

Accepted Answer

Remove cerumen with irrigation or manual extraction

Answer

Prescribe high-dose oral steroids

Answer

Start systemic antibiotics

Answer

Order brain MRI

Answer

Schedule cochlear implantation

Cerumen impaction — USMLE Step 3 MCQ

A 72-year-old man has reduced hearing and fullness in the right ear. Otoscopy shows obstructing cerumen, and the tympanic membrane cannot be visualized. He has no ear pain, fever, diabetes, or tympanostomy tube. Which of the following is the most appropriate next step in management?