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Introduction to Otoscopy
Otoscopy, an integral part of every doctor’s routine physical examination, is a medical procedure that involves taking a look into our ears and down our ear canals using an instrument called an otoscope. The purpose of otoscopy is to examine whether the different parts of the ear, which include the pinna, the external and internal auditory canal, and the eardrum, are all in good condition. Looking into the state of these structures can spell the difference between ignorance and prevention of some serious medical illnesses associated with hearing loss. Aside from general check-up procedures and routine screening, otoscopy is also done during extensive hearing assessments, before taking an impression of the ear for hearing aid fitting, and in the assessment of hearing aids. Usually sold in sets with ophthalmoscopes, otoscopes are standard tools in every doctor’s arsenal.
The otoscope as a tool began in the mid-1300s in France, used to study the aural and nasal passages. During the 19th century, many other otoscope varieties arose, all serving the same, original purpose. The funnel-shaped speculum, which is how the modern otoscope looks like today, was invented in 1838, and the pneumatic otoscope was invented in 1864, used to observe how the tympanic membrane reacts to air pressure. The binocular otoscope, meanwhile introduced for surgical use, was invented in 1872 and revolutionized ear surgery for its time. Today, because of the tool’s versatility, the modern otoscope can also be used to observe the nasal passages of patients, as well as the upper throat and the oral cavity. What used to be a simple tool addressing the cause of ear pain in patients has now evolved into the sophisticated instrument that serves a variety of uses in the medical setting today.
Guide to Parts
Though seemingly a complex instrument, the key concept upon which the otoscope operates is simple–it is a tool that provides a concentrated source of illumination with magnification incorporated in the easy-to-hold structural design. Otoscopes usually consist of three primary parts–the handle, the head, and the cone. The handle is where the power source is located, either in the form of an electrical component to be plugged into a wall socket, or an enclosure for batteries. The head of the otoscope includes the most important component of the instrument, the manual focus halogen or incandescent bulb, with an easily adjustable intensity of light. The head of the otoscope is also where the eyepiece is located. Meanwhile, the cone part of the otoscope’s head is appropriately shaped to fit inside a patient’s ear, as well as the nose and throat. This particular part of the instrument is designed to be fitted with speculae or ear tips, which are separate, detachable components of the otoscope usually made of plastic and disposable material. Shaped like a cone with holes at both ends, the speculum goes on top of the head of the otoscope and is used to focus the light onto the ear canal. Specula are produced in various diameters and lengths to fit different patients’ ear sizes, permitting safe and sanitary visualization of the inner ear. It is recommended that the largest possible size of the speculum is used to allow for the most amount of light to enter the patient’s ear canal. Common sizes for disposable speculums are 2 mm for infants, and, 3 mm, 4 mm, and 5 mm for adults.
The head of the otoscope is also equipped with a hole for an insufflator, another separate piece that provides a small air vent connection that lets the doctor to puff air into the ear canal. This technique, called insufflation or pneumatic otoscopy, allows the doctor to assess the mobility of the eardrum by observing how it responds to varying levels of air pressure.
How It’s Used
A complete assessment of the ear requires a systematic examination of its external and internal structures. The first s