Otoscopy: indications, preparation, conduct
What is otoscopy? Most of the people on this question certainly can not answer. So, when an otolaryngologist (ENT doctor) puts on the forehead in a special mirror, so he is prepared to examine the outer ear and the middle ear. This is called examination and otoscopy of the ear.
OTO-external examination of the ears is familiar to all. According to statistics, about 80% of people in childhood suffered from external or otitis media, and 20% suffered labyrinthitis – inflammation of inner ear. Adult OTO-examination will, in many cases, even if the ears don’t hurt. For example, after traumas and contusions to the head, in connection with diseases of the nose and throat, an upcoming cosmetic surgery, and in some cases the dentist will suggest to be sure to go to the «ear-throat-nose».
Tools and equipment
To conduct OTO-inspection a minimum set of bright lamps, headlamps, mirror reflector, different sizes disposable or reusable ear specula, pneumatic funnel Sigle and magnification. Today, however, otolaryngologists private clinics, public hospitals and a well-equipped outpatient ENT clinics have in the Arsenal of microscopes and special equipment – otoscopes. These modern hand tools allow you to perform OTO-visual diagnosis more efficiently, and also to conduct additional studies or surgical procedures.
Diagnostic Otoscope is a device with built-in LCD gauge, optical magnifier, xenon lighting element and insufflation. It can be used to hold the blowing evstafievich pipes and physiotherapy on the eardrum. Operating Otoscope additionally has a special channel. With it combined various tools to perform simple medical-surgical procedures, for example, puncture (auripuncture) or incision (paracentesis) of the eardrum.
Price electric otoscopy in private rooms depends on the skills of a consulting physician, the number of active service personnel, cost of equipment and the number of necessary manipulations, for example, purification of pus, paracentesis and/or retrieval of material for biopsy. According to doctors, as well as reviews of adults and children, diagnosis, conducted with the help of the Otoscope, is quick and painless. If the ear is already sore, otoscopy will not cause additional pain.
Not worth to save on the diagnosis of ENT diseases. It should be aware that the correct interpretation of this examination depends on physician experience and skill, your chosen specialist.
Timely and correct diagnosis is the key to rapid recovery resulting pathologies that are neglected can result in restriction or loss of hearing.
Training is required
Any visit to the doctor requires some training. Before carrying out otoscopy don’t need to drink any special preparations, however you need to prepare the ears for examination – clean the ear canal from Kumanovo epithelium and sulfur. You can do special ear scrapers, cotton swabs or terrorismeschaden liquid.
However, do not too zealous. It should be just as neatly as daily hygienic procedures. Excessive force may lead to violation of the integrity of the skin, damage to the eardrum, the emergence of cerumen. If your ear hurts, then there is no independent preparation to do.
The standard of conduct
Diagnostic otoscopy is carried out according to the traditional scheme. The examination takes place in the following order:
- Purification (if necessary) the ear canal from sulfur crusts, pus, blood clots.
- Inspection, palpation and pressure on the ear canal, tragus, mastoid process, and the line of its attachment to the ear.
- Percussion (tapping) of the mastoid process.
- The introduction of ear funnel the maximum width for a more detailed inspection of the walls of the auditory canal, the entire area of the eardrum and the lines separating the wall membrane. Visualization is with a magnifying glass, microscope or Otoscope.
- With the aim of preventing errors in detection of the perforation of the ear possible the procedure of purification from sulfur crusts. If purification is not possible, then the procedure is terminated and the patient is prescribed 2-3 days to dig 5 drops of paraffin oil 2-3 times a day. Ear wash water is prohibited. After that, the survey is conducted again.
- If necessary, specify the presence of perforation of the tympanic membrane (when the membrane is scarred or there is an internal cavity epidermization of the middle ear) to the eardrum slightly touch probe.
- The examination using a pneumatic funnel Sigle to conclude that the mobility of the eardrum.
After diagnostic examination OTO-no more time for «rehabilitation» is not needed. But you have to be mentally prepared for the fact that in case of detection of a purulent inflammation, the doctor will ask to do x-rays of the temporal bone.
Approximately 55% of people damage to eardrums, especially slit-like gaps, heal on their own.
Don’t panic and in the diagnosis of small perforations, as it is when healing leave no trace. Larger damage membranes, require careful treatment because they can lead to hearing loss.
Indications and contraindications
For OTO-diagnostic tests there are many indications, so we list only the main ones:
- lowering the level of hearing;
- pain in the ear;
- mechanical damage to the ear;
- discomfort or soreness in the perception of sounds of different frequency and power;
- itching, or splashing noise in the ears;
- hit or the feeling of presence of a foreign body;
- the selection of the ear canal pus or mucus crovatoi;
- suspicion of external or internal otitis, as with damage, and without;
- evstahiit, eczema, boils, polyps, and other pathology;
- control of the state organs of the inner ear after mechanical injuries of the head;
- selection or replacement of a hearing aid.
But contraindications for OTO-examination does not exist. The only thing that can hinder and lengthen the time the testing is excessive tortuosity of the ear canal. In certain injuries of the head and ear, OTO-passing inspection will be simply pushed back in time.
Modern video technology
If the usual OTO-inspection or examination by electric Otoscope is detected pathology and, if the audiologist you have any doubts or difficulties with the differentiation of the diagnosis, the patient may be prompted to complete the study using a more modern device – videoteka. This tool is equipped with several miniature video cameras and connected to a large monitor. Video otoscopic study has a number of advantages.
First, there is the possibility of conducting research doctors. In this case, and the patient has the opportunity to see the pathological changes inside the ear.
Second, this procedure ear examination already allows you to take pictures or produce video with which the patient may seek advice from other medical or diagnostic facility. This information will be useful to doctors and hospital, if after inspection a decision will be made about admission. Having the original video, your audiologist will be easier to assess the adequacy of treatment regimens.