otoscopy

Otoscopy is a diagnostic examination of the ear, performed with an otoscope to visualize the external auditory canal and the tympanic membrane (eardrum). It is used to assess ear pain, hearing loss, discharge, trauma, and other signs of ear disease.

A typical otoscope consists of a handle, a head with a light source and magnifying lens, and a disposable speculum that fits into the ear canal. The examiner inspects the canal for cerumen, discharge, or lesions and then uses the speculum to illuminate and view the tympanic membrane. In adults and older children the pinna is gently pulled up and back to straighten the canal; in younger children the pinna is pulled down and back.

Normal findings include a pearly, translucent tympanic membrane with intact landmarks, a cone of light, and an unobstructed canal. The tympanic membrane should be mobile when assessed with pneumatic otoscopy, which applies a small puff of air to evaluate membrane movement and middle-ear pressure.

Common abnormalities visible by otoscopy include cerumen impaction; otitis externa, indicated by canal edema or discharge; acute otitis media with a bulging or immobile tympanic membrane; otitis media with effusion, which may present with a dull or retracted membrane; and perforation or chronic changes such as cholesteatoma or tympanosclerosis.

Otoscopy is routinely used in primary care and ENT settings to diagnose ear disease, guide treatment, and determine the need for further evaluation, imaging, or referral. Variants include video or digital otoscopy and pneumatic otoscopy to assess tympanic membrane mobility.