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- should be held delicately but with full control.
The hand holding the instrument should be steadied against the cheek, this prevents
injury to the ear if the patient happens to move suddenly
- it can be held
in either a pencil grip or a hammer grip (1)
- it should always be held
in the hand of the same side as the ear about to be examined (1)
pinna should be gently retracted to straighten the ear canal - if this manoeuvre
is painful one should suspect inflammatory conditions of the external ear
if superficial wax is present in the outer canal (that can be easily removed)
then this is removed to improve the visual field seen via otoscopy
whole of the tympanic membrane should be examined if possible
- special attention
should be payed to the superior part, the pars flaccida, as destructive ear disease
may be apparent here.
- general steps to follow include:
- to look at the external canal wall
- visualization of the tympanic membrane
- is the tympanic membrane intact?
- is the colour and transparency
of the tympanic membrane normal?
- it is a diagnostic technique used to assess the tympanic membrane (2)
is the primary tool for diagnosing middle ear effusion in acute otitis media or
otitis media with effusion.(3)
- it provides a qualitative measure of tympanic
membrane mobility (3)
- a pneumatic attachment to the otoscope allows the
mobility of the tympanic membrane to be assessed.
- the features that can
be assesed are:
- the landmarks
- using pneumatic otoscopy
(qualitative) with tympanometry (quantitative ) improves the accuracy of diagnosis
Last reviewed 01/2018