How to use an Otoscope

An otoscope also referred to as an Auriscope, is a medical instrument used by medical personnel to visualize the inside of an ear.

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Otoscopy procedure is done to evaluate ear complaints and visualizes the external auditory canal, middle ear, and tympanic membrane. The procedure is also used in the diagnosis of acute otitis media – inflammation of the middle ear, cholesteatoma, and traumatic perforation of the tympanic membrane. It can also visualize foreign bodies stuck in the ear.

Principle

Just like a light microscope, an Otoscope shares the same principle. It has a light source to illuminate the inner an ear. A magnifying lens for magnification. A mirror to help reflect light. An operculum ensures sufficient room for observation. The body tube acts as a handle.

Step-by-step procedure on how to use an otoscope

1. Assemble the otoscope.
2. Pick and fit the largest speculum that can accommodate the patient’s external auditory canal – this will ensure sufficient lighting into the ear.
3. Hold the speculum preferably like a pen between the first and second finger. Use the left hand while assessing the left ear and the right hand while assessing the right ear.
4. Place your free fifth finger against the cheek of the patient to brace and support the hand during examination.
5. With the other hand, gently grasp and pull the patient’s pinna to straighten the external auditory canal. This will help visualize the tympanic membrane.
6. In an adult, pull the pinna posteriorly and superiorly. In a child, pull the pinna posteriorly and inferiorly.
7. Gently insert the speculum into the external auditory canal.
8.  Inspect the canal and check for inflammation, discharge, cerumen, and infection.
9. Slowly advance the speculum until you can visualize the tympanic membrane.
10. Check for color, presence of perforation, and a bulging appearance.
11. Inspect tympanic membrane landmarks, i.e.the pars flaccida on the superior aspect of the tympanic membrane, the pars tensa on the posterior aspect, the light reflex on the inferior and anterior aspect, and the handle of the malleus on the anterior aspect.
12. After satisfactorily evaluating the auditory canal gently remove the otoscope from the patient’s ear.