2023-04-27 16:30:36
Otoscopy is a frequent medical examinationwhich allows you to assess the condition of the outer ear and eardrum using a specific instrument, l’otoscope. The latter gives a good overview of the external auditory canal and the eardrum and allows general practitioners, ENT doctors or pediatricians to ask an informed diagnosis. When and how to perform an otoscopy? Does it involve risks? We take stock.
Definition: what is an otoscopy?
Otoscopy is visual ear examination which can be carried out by a general practitioner or a specialized doctor if he suspects a particular impairment of the ear or if his patients complain of pain, buzzing, hearing loss, etc.
Concretely, following the interrogation, within the framework of the clinical examination, the doctor uses a specific device, the otoscope, to auscultate different parts of the ear : the pavilion and the circumference of the ear, but also the external auditory canal and the eardrum.
Quick and painless, this examination does not normally require any preparation and does not suffer from any contraindications. However, otoscopy can sometimes be painfulespecially in the case of otitis externa, and sometimes doctors need to “clear the ground” by disinfecting the ear and cutting some hairs with pliers to increase visibility in the ear canal.
Otoscope, binocular microscope, oto-endoscope… Which instruments to perform an otoscopy?
Contrary to popular belief, doctors can use several instruments to carry out an otoscopy:
- an otoscope, the most widely used instrument that can be handled with just one hand. It consists of a handle and a head comprising a low-magnifying magnifying glass, an intra-auricular lighting system and a disposable tip (to prevent the transmission of auricular infections);
- a binocular microscopewhich has the advantage of presenting several levels of magnification, which makes it possible to better observe any anomalies,
- et an oto-endoscope, equipped with a lighting system and a small camera connected to a very small pipe which passes through the ear and makes it possible to obtain panoramic images of the ear on a screen. Thus, patients can directly see the contents of their ear and better understand the explanations of their doctor.
What do we see and how do we see in an otoscope?
As indicated above, the otoscope makes it possible to observe several parts of the ear:
- the pavilion and the circumference of the ear (he is particularly interested in their color, their sensitivity and texture, etc.);
- the external auditory canal (its walls, content, orientation, dimensions, etc.);
- and the eardrumwhich separates the middle ear from the outer ear (its integrity, mobility, color, etc.)
It also allows inspection of the smaller structures of the middle ear, such as the ossicles of the earwhich transmit sound vibrations from the outer ear to the inner ear.
Note: because of its low magnifying power and its low maneuverability, it is often seconded, even replaced automatically, by the instruments mentioned above: the binocular microscope and the oto-endoscope.
Find below, a diagram of the anatomy of the ear to help you identify its different segments.
Serous otitis, cholesteatoma, earwax plug… When and why should you have an otoscopy?
There are many indications for otoscopy: it is performed as part ofa routine examination and can also be used in more specific cases to diagnose or monitor outer and middle ear problemslike otitis.
It is therefore essential in particular in the event of:
- ear pain (otalgia), to diagnose a possible ear infection, obstruction or injury.
- hearing loss or declineto diagnose a possible infection, an accumulation of earwax or damage to the eardrum;
- discharge of blood or pus from the earlinked to an infection, a more or less severe injury, the presence of a foreign body, an abscess, a cyst, a cholesteatoma, etc.
In addition, otoscopy can be useful following treatment, to monitor a formerly affected area et assess the effectiveness of said treatment.
Please note: this examination must be performed by a qualified healthcare professional. Under no circumstances should it be improvised with the means at hand at home, without medical supervision. You risk making an already critical situation worse.
What can be the additional examinations following an otoscopy?
After an otoscopic examination, to complete his diagnosis, the doctor can prescribe or directly carry out several examinations, in particular:
- audiometrywhich assesses the level of hearing;
- an acoumetrywhich makes it possible to specify the type of deafness (conductive deafness or perceptual deafness) – if there is deafness;
- and/or an impedance testwhich consists of testing the mobility of the eardrum (tympanometry).
If an infection is suspected, a bacterial culture can also be performed to identify the cause of the infection and determine the appropriate treatment.
Which doctors can perform an otoscopy?
As you will have understood, several categories of doctors can perform an otoscopy, but not all will necessarily benefit from the same equipment: general practitioners, pediatricians and otolaryngologist (ENT) doctors are most affected.
Procedure: how to properly perform a pediatric otoscopy? And in adults?
First of all, the doctor will update on deleterious symptoms : their date, their order, their context and their frequency of appearance, but also their impact on the daily lives of patients. He will then take the time to comfortably install his or her patient on a chair to limit false movements and their painful consequences.
To start, he will examine the presumed “healthy” ear to be able to compare it with the “diseased” ear (provided that both ears are not diseased). He will inspect in turn the pavilion of the ear, thee external auditory canal and the ear-drum looking for anomalies in texture, color or configuration. Objective ? Get a clear idea of the pathology potentially involved.
What are the risks inherent in this ENT examination?
In theory, otoscopy is a painless examination with few risks. However, as noted above, patients may be unwell if the ear is inflamed or infected. Furthermore, since the skin of the auditory canal remains fragile, it can be injured when the otoscope is introduced into the ear, due to excessively strong and prolonged contact once morest the eardrum, for example. In very rare cases, if the child is very restless, for example, there is a minimal risk of tyrannical perforation.
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