Ear Exam with an Otoscope

Definition

An otoscope is a hand-held instrument with a tiny light and a cone-shaped attachment called an ear speculum, which is used to examine the ear canal. An ear examination is a normal part of most physical examinations by a doctor or nurse. It is also done when an ear infection or other type of ear problem is suspected.

Purpose

An otoscope is used to look into the ear canal to see the ear drum. Redness or fluid in the eardrum can indicate an ear infection. Some otoscopes can deliver a small puff of air to the eardrum to see if the eardrum will vibrate (which is normal). This type of ear examination with an otoscope can also detect a build up of wax in the ear canal, or a rupture or puncture of the eardrum.

Precautions

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

Description

An ear examination with an otoscope is usually done by a doctor or a nurse as part of a complete physical examination. The ears may also be examined if an ear infection is suspected due to fever, ear pain, or hearing loss. The patient will often be asked to tip the head 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 is inserted into the ear, and may adjust the position of the otoscope to get a better view of the ear canal and eardrum. Both ears are usually examined, even if there seems to be a problem with just one ear.

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. The speculums 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.

Risks

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.

Normal results

The ear canal is normally skin-colored and is 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 ear drum.

Abnormal results

An ear infection will cause the eardrum to look red and swollen. 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.

ORGANIZATIONS

American Academy of Otolaryngology-Head and Neck Surgery, Inc. One Prince St., Alexandria VA 22314-3357. (703) 836-4444. <http://www.entnet.org>.

Ear Foundation. 1817 Patterson St., Nashville, TN 37203. (800) 545-4327. <http://www.earfoundation.org>.

Hearing Health Information. 2100 W. 3rd St., Los Angeles, CA 90057. (213) 483-4431.

National Institute on Deafness and Other Communication Disorders. National Institutes of Health, 31 Center Drive, MSC 2320, Bethesda, MD USA 20892-2320. (800) 241-1044. <http://www.nidcd.nih.gov>.

OTHER

"Ear Test." HealthAnswers.com. <http://www.healthanswers.com>.

Altha Roberts Edgren

KEY TERMS

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

Otoscope—A hand-held instrument with a tiny light and a funnel-shaped attachment called an ear speculum, which is used to examine the ear canal and eardrum.