Ear Examination: Procedure, Risks, and Results
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Ear Examination

What is an ear examination?

Highlights

  1. Ear exams are performed for various reasons, such as earaches or head injury.
  2. An ear examination has few risks.
  3. Doctors can usually diagnose an ear infection based on the symptoms and the visible condition of the ear canal, eardrum, and middle ear.

Your doctor will perform an ear examination, or otoscopy, if you have:

  • an earache
  • an ear infection
  • hearing loss
  • ringing in your ears
  • any other ear-related symptoms

Your doctor can examine your ear to diagnose an ear infection or to see if treatments for an ear condition are working. Ear infections are common, especially in children.

Why is an ear examination performed?

purpose

Your doctor may also perform an ear exam if you’ve had or are experiencing the following:

An ear exam may be slightly uncomfortable or painful if you have an ear infection. Your doctor will stop the exam and remove the otoscope if the pain worsens.

How is an ear examination performed?

Process icon

Your doctor may dim the lights in the exam room to make it easier to see your ear canal and eardrum with an otoscope. An otoscope is a handheld light with a removable plastic tip shaped like a cone that allows the doctor to look inside your ear.

Your doctor will gently pull in the following directions to straighten your ear canal:

  • up
  • down
  • forward
  • back

Then, they’ll place the tip of the otoscope into your ear and shine a light into your ear canal and down to your eardrum. They’ll carefully rotate the otoscope in different directions to see the inside of your ear and your eardrum.

Your doctor may use a pneumatic otoscope, which has a plastic bulb on the end, to blow a small puff of air against your eardrum. Normally, this air will cause your eardrum to move. Your doctor will see little or no movement if you have an infection and fluid buildup behind your eardrum.

Young children will be asked to lie on their backs with their heads turned to the side to allow the doctor to examine one ear at a time. Older children and adults can sit up, tilting their heads to the side to allow the doctor to examine each ear.

You can purchase an otoscope to check your child’s ears at home if you think they may have an ear infection. Contact their doctor right away if you see any of the following in your child’s ears:

  • redness
  • swelling
  • fluid
  • pus

What are the risks associated with an ear examination?

process

There are very few risks associated with an ear exam. If your doctor doesn’t change the tip of the otoscope or clean it properly after examining your ear, they can spread the infection from one ear to the other.

What do the test results mean?

Risk Factors

Normally, your ear canal is skin-colored and your eardrum is light gray or pearly white. The light should reflect off of a healthy eardrum. You may also have some yellow or brown earwax, which isn’t harmful. If your ear canal and eardrum appear healthy, you mostly likely don’t have an ear infection.

If your doctor identifies any of the following in your ear canal or behind your eardrum, you most likely have an ear infection:

  • redness
  • swelling
  • amber liquid
  • pus

If the light doesn’t reflect off of your eardrum, it’s another indication that fluid may have collected behind the eardrum due to an infection.

What is the outlook?

Results/Exams

Ear infections are generally easily diagnosed based on the symptoms and the observations the doctor makes by looking at the eardrum.

If you don’t respond to the antibiotics your doctor prescribes and your symptoms don’t get better, there are other diagnostic examinations your doctor can perform to identify the cause of your discomfort. Here are some other tests that your doctor might run if this happens:

  • Your doctor can use tympanometry to look specifically at an infection in the middle ear, which is behind the eardrum.
  • During a tympanocentesis, your doctor inserts a tube into the ear and pierces the eardrum to drain fluid. Doctors rarely perform this test.
  • Your doctor can use acoustic reflectometry to measure how much sound your eardrum reflects. The more sound your eardrum reflects back, the more pressure from fluid your eardrum likely has. 

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