Human auditory channels are very narrow and extremely sensitive to mechanical influences. When a tactile examination is not enough to detect painful processes in the ear, otoscopy is used - a productive and safe procedure for visual examination.
The essence of the procedure
One of the main methods of diagnosing the hearing organs is a thorough examination of the ear canals and eardrums with the help of an otoscope. The device is equipped with different in diameter replaceable funnels, the size of which the doctor selects individually for each patient.
The funnel is inserted into the ear canal, and when using additional light sources, the otoscope allows you to visually identify the abnormalities present in the ear.
How the otoscopy is performed
Indications
- Preventative inspection.
- Painful sensations, itching.
- Symptoms of inflammation.
- Purulent discharge.
- Impairment of hearing.
- Damage to the tympanic membrane.
- Injury to the external ear.
- Ear bleeding.
- Evaluation of the structure of the hearing organs when choosing a hearing aid.
Diagnostic otoscopy
Any abnormalities in the diagnosis of auditory canals are judged by the doctor as a manifestation of the symptoms of certain diseases or disorders. Otoscopy can detect the following pathological changes:
- Partial or complete obstruction of the ear canal( sulfur plugs, foreign bodies).
- Watery, purulent and bloody discharge, which can be caused by head injuries, polyps, otitis, furunculosis, mastoiditis, otomycosis.
- Hyperemia - reddening of the tympanic membrane( the degree of spread and intensity of inflammation play a role).
- Modification of the tympanic membrane( thickening or retraction), its shape and mobility.
- When the eardrum ruptures, the character of the contents of the cavity( sulfuric, purulent or combined) is determined.
Get a clear diagnostic picture allows modern otoscopes, taking into account the latest optical and lighting technology.
In the photo the tympanic membrane: a) the norm;b) Inflamed;c) filled with pus;e) with perforation
Technique for conducting
Depending on the type and design of the otoscope, the light sources and its directivity may differ, but the description of the nature and the order of the steps of the diagnosis in all cases is the same.
Preparation of
- Mandatory sterile instrumentation.
- Preliminary examination of the ear canals in order to find out whether there are any contraindications and obstacles to the otoscopy.
- Removing ear plugs if any.
- When accumulating pus and epidermis in the ears, the ear canals are previously cleaned with a piece of cotton wool or washed with warm liquid. When rupture of the tympanic membrane for this purpose, solutions of potassium permanganate, furacilin or rivanol are used.
- The otoscope funnel is selected, corresponding to the diameter of the ear canal.
- Do not use ear drops for a few hours before the diagnosis.
Conducting the
- The light source is set so that it is at the ear level of the seated patient.
- Inspection begins with a healthy ear in order to study the individual structure of the ear canals.
- The doctor, carefully pulling the auricle slightly upward, straightens the auditory canal.
- The doctor heated to the body temperature of the otoscope, rotating, inserts into the ear to a depth of 1 to 1.25 cm.
- The entire examination takes 5-10 minutes. This is a completely painless process, but with pathological processes, unpleasant sensations can arise.
How otoscopy of the external ear is performed, see in our video:
Features of children
In a newborn baby, the size of the tympanic membrane is almost the same as that of an adult, but the outer ear canal is already considerably and often filled with original grease. The very membranes are extremely sensitive, which complicates the procedure of diagnosis, it requires preliminary careful cleaning of the ear canals and special care.
To older children, otoscopy is performed with the help of an adult assistant, who, having seated the child on his lap, fixes his head on his chest, thus eliminating the possibility of accidental injury when viewed. The child's hands hold the second hand, and the legs are clamped between the knees.
How is the diagnosis of ENT diseases:
Contraindications
Otoscopy is an absolutely safe procedure, there are no direct contraindications to it. There are only a few factors that make it difficult to conduct.
- Congenital ear anomalies.
- Traumatic injuries that caused obstruction of the ear canal.
- Severe edema.