FMCSA Medical Examiner Handbook
When seen by you three months ago for a routine physical exam, he had an asymptomatic middle ear effusion on that same side. Describe your clinical impression and plan if ear exam today showed: Normal landmarks and anatomy. The absence of middle ear findings should raise index of suspicion for referred pain from other head/neck problems (e.g. TMJ dysfunction, sinusitis, dental problems), and ... ................
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