Saunders is an associate professor of otology neurotology at dartmouth hitchcock medical center where he teaches aspects of otology and neurotology to medical students, residents and undergraduate students. An otoscope is a handheld light with a removable plastic tip shaped like a cone that allows the doctor to look inside your ear. It may take many examinations to become comfortable. Pdf optimizing otoscopy competency in audiology students. Look for any wax, swelling, erythema, discharge, foreign bodies or bony swellings. Ability to rule out obvious abnormalities or potential disease problems 3. After a veterinarian becomes familiar with the normal canine and feline ear, pathologic changes should be easy to identify.
The normal tympanic membrane moves in response to pressure. Otoscopy can identify or rule out disorders of the outer ear and middle ear disorders involving the ear drum 2. Please inform a member of staff if equipment is damaged or about to run out. Assessment of hearing with tuning fork and clinical speech reception thresholds e. This video produced by students at oxford university medical school in conjunction with the ent faculty demonstrates how to perform an examination of the ear using an otoscope. An otoscopy is an ear examination with an otoscope, a handheld instrument with a tiny light and a coneshaped attachment called an ear speculum. Examinationdiagnosistreatment pdf despite the many advances in diagnostic technologies and imaging modalities in recent years, otoscopy remains the first diagnostic option in the diagnosis of otologic disease. Your doctor will perform an ear examination, or otoscopy, if you have. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This information is brought to you in partnership with welch allyn. Top of auricle should be abo ve line drawn between outer canthus of eye and occipital protuberance. Using otoscopes in ear examinations uk medisave uk view. In some cases, a complete otoscopic examination is not possible on the first visit, and the animal may require antiinflammatory medications or otic flushing to visualize the entire ear canal as well as the tympanic membrane. The newborn physical examination assessment of a newborn with joan richardson joan richardsons assessment of a newborn what follows is a demonstration of the physical examination of a newborn baby as well as the determination of the gestational age of the baby using the dubowitz examination.
An embellishment of the diagnostic otoscope, the siegle examining otoscope fig. It is a supplement to the minnesota department of health mdh recommended hearing. Otoscopy pathologies the tympanic membrane, or ear drum, serves as the window into the middle ear. An otoscope is the instrument for examining the ear, as illustrated in picture below. Data from 1941 participants 48 to 91 years of age were used to compare otoscopic and tympanometric results. Continue to follow the vertical canal by looking through the otoscope and advancing down.
Otoscopy basics of otoscopy using an otoscope, this is a simple outpatient examination that provides information about the external auditory canal, the tympanic membrane and some aspects of the middle ear too. The experienced audiologist will find this a useful reference text to consult after viewing questionable ear pathology in everyday practice. Aug 15, 2014 this feature is not available right now. Optimizing otoscopy competency in audiology students through supplementary otoscopy training article pdf available in journal of the american academy of audiology 249. The ear speculum a coneshaped viewing piece of the. Ear examination otoscopy rinnes webers geeky medics. Hearing loss severe enough to interfere with speech is experienced by approximately 8 percent of u. Otoscopy basics of otoscopy oxford medical education. A guide to the use of diagnostic instruments in eye and. An otoscope is a medical device that transmits a narrow bright light which allows the technician to see if your employee has something in their ear canal that may alter the hearing test. Otoscopy and typanometry manual minnesota department of health. In order to get the best view of the ear drum, the viewer will have to move both the outer ear and the otoscope up and down or back and forth. The patient was diagnosed with todds paralysis and newonset seizure disorder. Example of otoscope used for examining the ear with reusable speculum.
Presents as a translucent, pearly nodule with rolled borders and telangiectasia. Slowly guide the speculum down the vertical ear canal. You may find one of our health articles more useful. Steps of the otoscope exam include inspecting the eac and the tm with its. A collection of high quality otoscopic photographs supplemented with brief clinical correlation, intraoperative photographs, and discussion of surgical approaches. An otoscope is an instrument with which we are all familiar. This otoscope used a perforated angled mirror to reflect the light from a lamp flame into the earcanal. Otoscopic examination of external auditory canals and tympanic membranes c. Feb 17, 2012 this video produced by students at oxford university medical school in conjunction with the ent faculty demonstrates how to perform an examination of the ear using an otoscope.
Purpose an ear examination is a normal part of most routine physical examinations by a doctor or nurse. Your doctor can examine your ear to diagnose an ear infection or to see if treatments for an ear condition are working. Investigation of middle ear anatomy and function with combined video otoscopyphase sensitive oct jesung park, 1 jeffrey t. Recommended procedure ear examination british society of.
Always remember that the ear canal is not straight. They are written by uk doctors and based on research evidence, uk and european guidelines. On completing the examination, the otoscope including the speculum shall be removed from the ear canal. Your doctor will gently pull in the following directions to. Although you may not know that much yet in your clinical career, you have one secret weapon as a student. Interexaminer relability of otoscopic signs and tympanometric. Investigation of middle ear anatomy and function with. British society of audiology 2003 procedure for processing documents. Pdf definition an otoscope is a handheld instrument with a tiny light and a coneshaped attachment called an ear speculum.
Any examination bullet that is not clearly related to the injury or a patients specific condition will not be. Clinical examination a comprehensive collection of clinical examination osce guides that include stepbystep images of key steps, video demonstrations and pdf mark schemes. Examination of the ear inspection external ear observe position and shape, inspect for symmetry, lesions, drainage from external auditory meatus position. Otoscopic definition of otoscopic by medical dictionary. This is performed in order to examine the external auditory canal the. Optimizing otoscopy competency in audiology students through supplementary otoscopy training. In children, the auricle should be pulled downward and backward. Definition an otoscope is a handheld instrument with a tiny light and a coneshaped attachment called an ear speculum. Otoscopic examination 14 15 with the otoscope in your dominant hand, gently introduce the tip of the speculum into the opening of the ear canal. Look down the otoscope whilst advancing the speculum. Upon examination of this patient, he had rightsided weakness which resolved within an hour. The canal and tm were viewed through the mirrors central perforation.
Immobility may be due to fluid in the middle ear, a perforation, or tympanosclerosis, among other reasons. Verify all of the completed examination components listed in the report are documented, including the relevancerelatedness to the injury and or reasonable and necessity for that specified patients condition. Seven categories of vo applications are presented with clinical examples. Use the largest ear speculum that the canal will accommodate allows better visualization of the tm insertion of the speculum into the posteriorbony portion of the eac causes pain and may damage the delicate skin of the canal. Since symptoms of ear disease are relatively few in number and frequently nonspecific, a clinical examination of the ear is important in the management of ear disorders. In nonclinical dogs without any apparent signs of otitis externa, only a quick otoscopic examination is necessary. Skin cancers most commonly occur on the face, particularly on the nose and ears, and so in any eyes, nose and throat examination you must be vigilant for skin lesions. The otoscopic exam is performed by gently pulling the auricle upward and backward. Mobile exam center components descriptions the following pages describe the exam components as offered in the mobile examination center. Otoscopic examination of the ear introductory background the ear is one of the easiest structures to study providing one stays to the outside of the tympanic membrane tm. Feb 05, 2016 pneumatic otoscopy is an examination that allows determination of the mobility of a patients tympanic membrane tm in response to pressure changes. Purpose is to ensure that ear canals are free of obvious problems before audio logic testing, tympanometry, or hearing aid fitting. Psychiatric description of patients judgment and insight examination for presence or absence of hernia.
To do otherwise requires a number of years of study and techniques and equipment not available at wncc. An otoscopic examination is the visual examination of the auditory canal and tympanic membrane using an otoscope. Pull the pinna upwards and backwards with your other hand to straighten. Hold the otoscope like a penpencil and use the little finger area as a fulcrum. Some patientshealthy or otherwisewill require sedation or anesthesia. A structured approach to ear examination, hearing assessment including rinnes and webers test and otoscopy in an osce setting. The lifeform ear examination simulator makes it possible to practice. Fiftytwo patients with unilateral cholesteatoma and 30 control subjects underwent otoscopic and audiologic examination.
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. Otoscopic examination the examination of the ear canal and tympanic membrane through the use of an otoscope. Mobile exam center components descriptions the following. The examination requires two hands, one hand to hold the ear and the other to hold the otoscope. Hold the otoscope in your dominant hand with the thumb and first two fingers close to the otoscope head, and the power base up, much like holding a pencil. Looking in ears and making a diagnosis is not easy, so practice every opportunity you have. Most of the time the culprit in this scenario is cerumen ear wax, though the discovery of an infection o. This includes an assessment of hearing as well as the appearance of the ear. A 3yearold female presents with abdominal pain and fever over the past day. An otoscope is an instrument which is used to look into the ear canal. Primary care otolaryngology an absolute commitment to honestyis a prerequisite for becoming a physician.
Examination of abdomen with notation of presence of examination of sensation e. Direct observation of the tympanic membrane and external auditory canal through an otoscope, offers valuable information about possible disease within the middle ear. This prevents injury should the patient turn suddenly. This process will move the acoustic meatus in line with the canal. Sullivan abstract recent advances in endoscopic optics and miniature video camera technology have made video otoscopy vo accessible to audiologists in a practical way. Otoscopy is an examination that involves looking into the ear with an instrument called an otoscope or auriscope. Clinicians perform an otoscope exam to assess the condition of the external. Oct 16, 2014 professional reference articles are designed for health professionals to use. Overall agreement for nine otoscopic signs ranged from 73 percent vascularity to 100 percent drainage.