Based on the salient features of this patient namely the pain in the ears, unusual sense of fullness, as well as hearing loss which is most likely conductive hearing loss; with a physical examination finding of an "accumulation of earwax", then the most likely impression for this case is impacted cerumen. Impacted cerumen happens when the cerumen gets accumulated inside the ears, hardens, and blocks the conduction of sound; preventing sound waves from being conducted to the ear drum. This also causes pain and ear fullness as the hardness of the cerumen may produce inflammation.