Patients with a history of earwax impaction should be advised to have their ears examined when they experience symptoms such as hearing loss, ear discomfort, or if the wax obstructs examination of the tympanic membrane. Routine or scheduled ear examinations solely based on a history of impaction without symptoms are not routinely recommended.
If earwax removal is indicated due to symptoms or the need to examine the ear, follow-up examinations should be symptom-driven rather than time-driven. Patients should be advised to return if they develop symptoms such as ear pain, discharge, itching, or hearing difficulties.
There is no specific recommended interval for routine ear examinations in asymptomatic patients with a history of earwax impaction. Watchful waiting is reasonable if the impaction is asymptomatic and does not prevent ear examination.