Otoscopic Examination

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Otoscopic Examination

Definition

An otoscopic examination is the visual examination of the auditory canal and tympanic membrane using an otoscope.

Purpose

An otoscopic examination is a procedure that examines the auditory canal and tympanic membrane for infection or blockage due to the presence of a foreign object or build up of wax, the tympanic membrane for signs of rupture, puncture, or hearing loss, and the canal for any variations from normal. Some otoscopes can deliver a small puff of air to the eardrum to determine if the eardrum will vibrate (which is normal). An otoscopic examinations is also part of a normal physical examination.

Precautions

No special precautions are required. However, if an ear infection is present, an ear examination may cause some discomfort or pain.

Description

An otoscopy is an ear examination with an otoscope, a handheld instrument with a tiny light and a cone-shaped attachment called an ear speculum. A physician or nurse usually performs an otoscopic examination as part of a complete physical examination. The ears may also be examined if an ear infection is suspected, or if the patient has a fever, ear pain, or hearing loss. The patient will be asked to sit with the head tipped slightly toward the shoulder so the ear to be examined is pointing up. The doctor or nurse may hold the ear lobe as the speculum of the otoscope is inserted into the ear. Both ears are usually examined, even if the problem seems to affect just one ear, and the procedure takes no more than a few minutes to perform.

Preparation

No special preparation is required prior to an ear examination with an otoscope. The ear speculum, which is inserted into the ear, is cleaned and sanitized before it is used. Specula come in various sizes, and the doctor or nurse will select the size that will be most comfortable for the patient's ear.

Aftercare

If an ear infection is diagnosed, the patient may require treatment with antibiotics. If there is a buildup of wax in the ear canal, it might be rinsed or scraped out.

Complications

This type of ear examination is simple and generally harmless. Caution should always be used any time an object is inserted into the ear. This process could irritate an infected external ear canal and could rupture an eardrum if performed improperly or if the patient moves.

Results

The ear canal is typically skin-colored and covered with tiny hairs. It is normal for the ear canal to have some yellowish-brown earwax. The eardrum is typically thin, shiny, and pearly-white to light gray in color. The tiny bones in the middle ear can be seen pushing on the eardrum membrane like tent poles. The light from the otoscope will reflect off of the surface of the eardrum. Abnormal results such as a red or swollen ear canal may indicate an ear infection is present. In cases where the eardrum has ruptured, there may be fluid draining from the middle ear. A doctor may also see scarring, retraction of the eardrum, or bulging of the eardrum.

KEY TERMS

Auditory canal— Ear canal.

Ear speculum— A cone- or funnel-shaped attachment for an otoscope that is inserted into the ear canal to examine the canal and the eardrum.

Otoscope— A handheld instrument with a tiny light and a funnel-shaped attachment called an ear speculum.

Tympanic membrane— Ear drum.

Health care team roles

The health care team should be aware of the physiology of the auditory canal to detect any deviations from normal. A knowledge of the function and care of the otoscope is important to ensure the light is bright, there are no loose parts, and if disposable speculums are not used, the speculums are sterilized between patients. Hospitals may offer training programs in the use of otoscopes and their detection of abnormalities of the auditory canal.

Resources

ORGANIZATIONS

American Academy of Otolaryngology—Head and Neck Surgery. One Prince Street, Alexandria, VA 22314. (703) 836-4444.

Ear Foundation. 2000 Church Street, Box 111, Nashville, TN 37236. (615) 329-7807. (800) 545-HEAR.

National Institute on Deafness and Other Communication Disorders. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice: (301) 496-7243. TTY: (301) 402-0252.