Outer ear problems
What the FAA's documents say about outer ear problems, in plain words, with the FAA's own words one press away.
FAA term: Outer Ear Abnormalities (Cerumen Impaction, Otitis Externa, Microtia)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
OUTER EAR ABNORMALITIES (Cerumen Impaction, Otitis Externa, Microtia) All Classes
Short version
The disposition table has three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AImpacted cerumen not affecting hearing, or otitis externa (resolved) | Examiner issues | Examiner can issue |
| Row BWith complications, incapacitating, or affecting hearing | Defers to the FAA | Special Issuance |
| Row CAn outer ear or external pinna abnormality, such as microtia | Examiner issues | Examiner can issue |
Show the FAA's words: the FAA's table for Outer ear problems
- Row A · Examiner can issue
Impacted cerumen not affecting hearing, or otitis externa (resolved) or not affect (as printed) flying/safety-related duties. If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60.
A. Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests: ISSUE Annotate this information in Block 60.
- Row B · Special Issuance
With complications, or incapacitating, or affecting hearing (unable to pass any of the acceptable hearing tests or the AME has concerns). The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. With complications OR Incapacitating OR Affecting hearing (Unable to pass any of the acceptable hearing tests or the AME has concerns) Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
- Row C · Examiner can issue
An outer ear/external pinna abnormality, such as microtia. The examiner should look closely at the affected ear for other visible signs of pathology, such as pre auricular pits or brachial (as printed) cleft cyst, or other evidence of a syndromic nature. If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60. The row's note says that if the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER.
C. Outer ear/external pinna abnormality (such as Microtia) The AME should look closely at the affected ear for other visible signs of pathology such as pre auricular pits or brachial cleft cyst or other evidence of a syndromic nature. If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests: ISSUE Annotate this information in Block 60. Note: If the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER
The FAA pathways for outer ear problems
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: what the examiner determines
Impacted cerumen not affecting hearing, or otitis externa (resolved) or not affect (as printed) flying/safety-related duties.For Row A, your AME determines the findings the row lists. If your AME can determine them, the table says ISSUE.
If the AME can determine
- The condition has no symptoms or current problems that would interfere with flight duties
- And the individual can pass any of the acceptable hearing tests
At the exam
- Your AME annotates this information in Block 60
Show the FAA's words: Row A: what the examiner determines
A. Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties
If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests:
ISSUE
FAA source: Outer Ear. FAA date 31 January 2024; checked by Crosscheck 14 October 2026.
ISSUE Annotate this information in Block 60.
FAA source: Outer Ear. FAA date 31 January 2024; checked by Crosscheck 14 October 2026.
Step 2: See your AME
If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60.Exam day- If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60.
Show the FAA's words: See your AME
A. Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests: ISSUE Annotate this information in Block 60.
FAA source: Outer Ear. FAA date 31 January 2024; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
If the examiner defersRow CExaminer issuesExaminer can issue
The examiner should look closely at the affected ear for other visible signs of pathology, such as pre auricular pits or brachial (as printed) cleft cyst, or other evidence of a syndromic nature. If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60. The row's note says that if the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER.
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Impacted cerumen not affecting hearing, or otitis externa (resolved) or not affect (as printed) flying/safety-related duties. If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60.
A. Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests: ISSUE Annotate this information in Block 60.
- Row B · Special Issuance
With complications, or incapacitating, or affecting hearing (unable to pass any of the acceptable hearing tests or the AME has concerns). The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. With complications OR Incapacitating OR Affecting hearing (Unable to pass any of the acceptable hearing tests or the AME has concerns) Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
- Row C · Examiner can issue
An outer ear/external pinna abnormality, such as microtia. The examiner should look closely at the affected ear for other visible signs of pathology, such as pre auricular pits or brachial (as printed) cleft cyst, or other evidence of a syndromic nature. If the examiner can determine the condition has no symptoms or current problems that would interfere with flight duties and the individual can pass any of the acceptable hearing tests, the table says ISSUE, and the examiner annotates this information in Block 60. The row's note says that if the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER.
C. Outer ear/external pinna abnormality (such as Microtia) The AME should look closely at the affected ear for other visible signs of pathology such as pre auricular pits or brachial cleft cyst or other evidence of a syndromic nature. If the AME can determine the condition has no symptoms or current problems that would interfere with flight duties AND The individual can pass any of the acceptable hearing tests: ISSUE Annotate this information in Block 60. Note: If the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER
If the examiner defersSpecial Issuance
The table marks Row B, with complications, incapacitating, or affecting hearing, DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, with complications, incapacitating, or affecting hearing, DEFER.
B. With complications OR Incapacitating OR Affecting hearing (Unable to pass any of the acceptable hearing tests or the AME has concerns) … DEFER Submit the information to the FAA for a possible Special Issuance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Row C's note also defers
Row B is, among others, affecting hearing (unable to pass any of the acceptable hearing tests or the AME has concerns), and it lists what to submit for a possible Special Issuance. Row C's note says that if the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER, and it lists nothing to submit. The table does not say whether Row B's list applies to that deferral.
Show the FAA's words: good to know, 2
B. With complications OR Incapacitating OR Affecting hearing (Unable to pass any of the acceptable hearing tests or the AME has concerns) Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. … Note: If the applicant is unable to pass any of the acceptable hearing tests or the AME has concerns, the AME should annotate this in Block 60 and DEFER
Row A's words, as printed
Row A reads "Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties". The page shows these words as printed.
Show the FAA's words: good to know, 3
A. Impacted cerumen not affecting hearing OR Otitis Externa (resolved) or not affect flying/safety-related duties
The table lists no hearing test
The ISSUE of Rows A and C rests in part on the individual being able to pass any of the acceptable hearing tests. The table does not list those tests.
Show the FAA's words: good to know, 4
AND The individual can pass any of the acceptable hearing tests:
The examiner looks closely at the ear under Row C
For an outer ear/external pinna abnormality, such as microtia, the table says the examiner should look closely at the affected ear for other visible signs of pathology, such as pre auricular pits or brachial (as printed) cleft cyst, or other evidence of a syndromic nature.
Show the FAA's words: good to know, 5
C. Outer ear/external pinna abnormality (such as Microtia) The AME should look closely at the affected ear for other visible signs of pathology such as pre auricular pits or brachial cleft cyst or other evidence of a syndromic nature.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.