| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Does individual report a recent history of severe pain behind the ear and high fever? Has individual had a middle ear infection recently? Was there a decrease in hearing, tinnitus, or dizziness?
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Has drainage from the ear occurred?
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On physical exam, were tenderness, erythema, and swelling over the mastoid area observed? Is purulent drainage present? Facial paralysis? Meningitis?
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Is the eardrum perforated, scarred, or completely eroded?
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Is drainage from the middle ear present in the ear canal?
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Has individual had a culture and sensitivity done on the drainage? Was CT or MRI performed? Were audiometric studies done?
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Were conditions with similar symptoms ruled out?
Regarding treatment:
- Was individual admitted to the hospital for intravenous antibiotic therapy?
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Has surgical drainage of the area been done?
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Has individual developed chronic mastoiditis? Is this being treated with surgical drainage and a prolonged course of antibiotics?
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Does individual need additional surgery to repair a residual perforation?
Regarding prognosis:
- Can individual's employer accommodate any necessary restrictions?
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Does individual have any conditions that may affect ability to recover?
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Have any complications developed such as the infection spreading to other areas of the head and neck? Facial paralysis? Thrombosis of the sigmoid sinus? Hearing loss?
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Source: Medical Disability Advisor