EXAMINATION OF THE EAR

1. The auricle is examined first for any abnormality such as in position, size, shape, color, consistency, tenderness, or accessory auricles.
2. The mastoid process is examined for signs of inflammation.
3. The External auditory canal: For discharge, pain sensation on moving,

Then an ear speculum is introduced in the external auditory canal after its straightening by pulling the auricle upwards and backwards in adults downwards and backwards in children.

N.B. Good illumination is essential for examination of the ear and can be provided by:

1. Reflected light by a head mirror.

2. Head light.

3. Battery powered Otoscope (Provides magnification).

4. Oto-microscope (Provides magnification).

5. Endoscopic Examination (Provides magnification).

The structures seen are:

1- The external auditory canal.

2- The tympanic membrane: The prominent landmarks on the membrane are

1. The handle of malleus, which normally runs downward and backwards towards the centre of the membrane (The Umbo).

2. The cone of light, which appears in the antero-inferior part of the membrane due to reflection of the examination light.

4- Pneumatic Otoscope (Siegle’s speculum): It is an ear speculum provided with air pump to increase or decrease air pressure in the external auditory canal and with a magnifying lens by 2.5 times.

Indications:

1. To test mobility of the tympanic membrane.

2. To detect small lesions of the tympanic membrane by its magnification.

3. To perform fistula test.

Category: ENT Notes