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Medical Video: Otoscopy (Ear Examination) - ENT
Definition
What is an ear examination at home?
Ear examination at home is an inspection of the ear canal and eardrum with a tool called an otoscope. Otoscopes are handheld instruments with lights, magnifying glass, and funnel-shaped observing places with narrow, pointed ends called speculators. Ear examinations at home can help detect many ear problems, such as ear infections, excessive earwax, or objects in the ear canal.
After receiving instructions and training from a doctor, ear examinations at home can be useful for parents who have small children who often get ear infections and earaches. The child may sometimes have an ear infection whose external symptoms may be fuss, fever, or tugging at the ear. Ear examinations at home may help find the cause of these symptoms. However, it can be difficult to learn to use an otoscope, and some poor quality otoscopes. Examination with a doctor is often needed.
When should I have an ear check at home?
Ear examinations at home can be done for:
- seeing signs of infection when people experience ear pain or small children have vague symptoms
- examine foreign objects in the ear such as insects or nuts
- check earwax stacks if people complain of hearing loss or blocked or depressed ears
Prevention & warning
What should I know before undergoing an ear examination at home?
Some otoscopes at home use sound waves that bounce inside the eardrum to detect otitis media with effusions (fluid in the middle ear). Earwax is a normal secretion that protects the ear canal. Earwax usually dries by itself, and you only need to clean the outside of the ear. Never clean the ear canal with cotton budhair clips, paper clips, or finger nails, which may damage the eardrum or eardrum and can push feces deeper into the ear canal.
Whatever you see with an otoscope, contact your doctor if you or your child has:
- severe ear pain, especially if the child has a fever
- sudden hearing loss
- dizzy
- can't move muscles on one side of the face (facial nerve palsy)
- one or both ears keep ringing
- discharge from one or both ears
Process
What should I do before undergoing an ear examination at home?
There is no special preparation needed before doing this test. Always remember to clean the ear speculum with warm soapy water before using it.
What is the process of checking the ears at home?
If you are going to examine a child, have the child lie down with his head sideways, or sit on the lap of an adult and rest his head on the chest of an adult. Older children or adults can sit with their heads slightly tilted towards the opposite shoulder. Sitting is the best position to identify otitis media with effusions (fluid behind the eardrum). Choose the size of the largest observation device that can fit into the ear canal tract. If only one ear has a problem, keep checking the other ear to make it easier to determine what is different from the sore ear.
If you examine the ears of children over 12 months or adults, hold the otoscope with one hand and use the other hand to gently pull the outer and back outer ears. This will straighten the ear canal and make it easier for you to see the inside. In infants under 12 months, gently pull the outer ear down and back. Now, slowly insert the pointed end of the observer into the ear canal while looking into the otoscope. The side of the ear canal can be very sensitive, so don't try to press the ear canal. Pile your hands over the face of the person being examined, so that your hands move along with their heads if they move quickly.
Do not move the photoscope forward without looking inside. Make sure you can see the path through the ear canal. You don't need to insert the observer very far into the ear because the light can spread to the end. Aim the tip of the observer slightly towards the person's nose to follow the normal channel angle. When looking through the otoscope, move it gently at different angles so you can see the walls of the duct and eardrum. Stop if the patient feels an increasing pain.
What should I do after undergoing an ear examination at home?
Ask the doctor to review this technique with you and to observe your examination. Then, practice it on healthy, willing adults so you can learn what normal eardrums and drums are like. Don't be disappointed if you can't see the eardrum initially because this requires practice and experience.
Explanation of Test Results
What do the test results mean?
Ear canal
Normal: ear canal varies in size, shape, and color. The ear canal is colored like a skin and contains fine hair and usually a number of earwax is yellowish brown or reddish.
Abnormal: pain appears when the outer ear is pulled or shaken. The ear canal is red, soft, swollen, or filled with pus.
Eardrum
Normal: eardrums are white like pearls or light gray, and you can see them. You can see the small middle ear bone pushing the eardrum. You see a cone-shaped light, called a "light reflex", reflecting the surface of the eardrum. This light cone is at 5 o'clock position on the right ear and 7 o'clock in the left ear.
Abnormal: light that bounces on the eardrum looks faded or absent. The eardrum is red and bulging. You might see a yellow bubble or fluid behind the eardrum, a hole in the eardrum (perforation), and white scar tissue on the surface of the eardrum. If your child has a hose in the ear, you might also see a small plastic hose that is usually blue or green. The eardrum is blocked by earwax or objects, such as nuts or beads.
Note: if you see an inflamed canal, pus, or eardrum that has a faded or red color, fluid behind the eardrum, a hole in the eardrum, or a foreign object in the ear, contact your doctor.
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