1. • Manipulation of pinna and otoscopic exam of the ear causes acute pain

2. For all groups the main determinant of improvement in mean hearing threshold was the otoscopic presence or absence of fluid.

3. Audiologist can perform otoscopic examinations of the ear canal and ear drum, checking for ear infections or cerumen (earwax) build-up which they can safely remove

4. Cerumen removal on the same date of service, the following criteria must be met: • The main reason for the patient’s visit was separate from the Cerumen removal • Otoscopic examination of the tympanic membrane is not possible due to the impaction