In ER today, I saw a 30 year old male with a 1-week history of decreased hearing from his right ear. He didn't have any pain complaints or fever. The symptom started after he came back from the beach last week. He tried some OTC ear drops and q-tips with no relief. He jokingly said that he feels like there's "a piece of grass or fish stuck in his ear." Otoscopic exam showed a complete blockage of the ear canal with some yellowish substance that is either cerumen or purulent discharge from an otitis media. I went ahead and lavage the ear and interestingly, a 5-cm piece of yellowish looking stripe came out - it's a piece of seaweed that got stuck in the ear. The patient has immediate relief.
Sometimes what one sees in an otoscope is deceiving - the piece of seaweed looks nothing like cerumen or pus once it's out of the ear. The childhood tale of "3 blind men examining an elephant" comes to mind.
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