| Subject | Contents |
| Definition | An examination of the ear using an instrument called an otoscope. |
| Alternative Names | Test for otitis media; Test for otitis externa; Otoscope; Test for ear infection |
| How the test is performed | Dim the lights in the room. Position a young child on the back with the head turned to the side. The child can also be held by an adult with the child's head resting against an adult's chest. Older children and adults may sit with the head tilted toward the shoulder opposite the ear being examined. The hand holding the otoscope should be securely braced against the side of the head so that sudden movements will be absorbed by the hand and not the otoscope. The outer ear is grasped by the free hand and gently pulled up, back, or forward, to help straighten the ear canal for better viewing. The ear speculum (a cone-shaped viewing piece of the otoscope) is slowly inserted into the ear canal while looking into the otoscope. The speculum is angled slightly toward the person's nose to follow the canal. The speculum is not inserted deeply. The light beam will extend beyond the viewing tip of the speculum. The otoscope is gently moved to different angles to view the canal walls and eardrum. The view may be blocked by earwax. |
| How to prepare for the test | The ear speculum (a cone-shaped viewing piece of the otoscope) should be cleaned in hot, soapy water and disinfected by soaking it in rubbing alcohol for at least 10 minutes. Select the largest ear speculum that will fit comfortably in the ear canal. Infants and children: The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:infant test or procedure preparation (birth to 1 year) toddler test or procedure preparation (1 to 3 years) preschooler test or procedure preparation (3 to 6 years) schoolage test or procedure preparation (6 to 12 years) adolescent test or procedure preparation (12 to 18 years) |
| How the test will feel | If an infection is present there may be some discomfort or pain. Stop the test if there is an increase in pain. |
| Why the test is performed | Examining the ear can reveal the cause of symptoms such as an earache , the ear feeling full, or hearing loss . In young children, the only symptoms of an ear infection may be tugging at the ear, crankiness, or fever . Examining the ear is a useful means of monitoring the effectiveness of treatments for some ear problems. |
| Normal Values | The ear canal varies in size, shape, and color. Normally the canal is skin-colored and has small hairs. Earwax may be present which is a yellowish-brown color. The ear drum is a light-gray color or a glistening pearly-white. The small bones of the middle ear usually are pushing on the eardrum membrane like tent poles. The cone of light, (light reflex) should be seen reflecting off the eardrum surface. |
| What abnormal results mean | Ear infections are a common problem especially with small children. Otitis externa (external ear infection) may be present if the ear canal is red, tender, swollen, painful when wiggling or pulling on the outer ear, or if the canal is filled with yellowish-green pus. Otitis media ( middle ear infection ) may be present if the light reflex is dull or absent. The eardrum may be red and bulging. Amber liquid or bubbles behind the eardrum are often seen if fluids collect in the middle ear. In either case, contact the health care provider if any of the symptoms are seen. Additional conditions under which the test may be performed:cholesteatomaotitis externa; chronicruptured or perforated eardrum |
| What the risks are | If the ear speculum is not disinfected, an infection can be spread from one ear to the other. |
| Special considerations | Not all ear problems can be detected by looking through the otoscope. If symptoms of severe ear pain ; hearing loss ; dizziness ; fever ; ringing in the ears ; or ear discharges/bleeding are present, see the health care provider. Earwax (normal protective secretion of the ear canal) is not dangerous and should not be removed by putting an object into the ear. There are several products available at drugstores that dissolve or soften the earwax so that it may be flushed out gently with warm water. It may take practice to be able to see the ear drum. |
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