The patient may complain of “wax in the ear,” a “stuffed-up” sensation, pain, itching, decreased hearing, tinnitus, dizziness, hearing aid malfunction, ear drainage, or ear odor. Symptoms may be sudden in onset if the patient put a cotton-tipped applicator down the ear canal or placed something like mineral oil into the ear canal in an attempt to soften the wax. On physical examination, there is often dark brown, thick, dry, or pasty cerumen, frequently packed down against the eardrum (where it does not occur normally), obscuring visualization of the ear canal and the tympanic membrane.