Otoscopy: A complete guide to ear examination

Otitis media is an inflammation of the middle ear, often caused by bacterial or viral infections. It is common in children due to their shorter Eustachian tubes.

How Does Otoscopy Help?

Otoscopy reveals:

• Redness and swelling of the eardrum.
• Fluid buildup behind the eardrum.
• Bulging or retracted eardrum.

Treatment Options:

• Antibiotics (for bacterial infections).
• Pain management with over-the-counter medications.
• Surgery (e.g., grommets) in recurrent cases.

Otitis externa is an infection of the outer ear canal, commonly known as swimmer’s ear. It is caused by moisture trapped in the ear, which promotes bacterial growth.

Otoscopy Findings:

• Red, swollen ear canal.
• Presence of pus or discharge.
• Pain when the outer ear is touched.

Prevention Tips:

• Keep ears dry after swimming.
• Avoid inserting foreign objects into the ear.

Cholesteatoma is a non-cancerous but aggressive skin growth in the middle ear. It can lead to hearing loss and damage to nearby structures if untreated.

How Does Otoscopy Detect Cholesteatoma?

• A white, pearly mass is visible behind the eardrum.
• Discharge with a foul odour may be present.
• Hearing loss is a common symptom.

Treatment:

• Surgical removal of the growth.
• Regular follow-up to monitor recurrence.

Otosclerosis is an abnormal bone growth in the middle ear, causing gradual hearing loss.

How Is It Diagnosed?

• Otoscopy may appear normal.
• Further tests (audiometry, CT scan) are required for confirmation.

Treatment:

•  Hearing aids for mild cases.
• Surgical intervention (stapedectomy) for severe cases.

A tear in the eardrum, caused by infection, trauma, or sudden pressure changes.

How Is It Detected?

• Otoscopy shows a visible hole in the eardrum.
• Symptoms include pain, hearing loss, and discharge.

Treatment:

• Most cases heal naturally within weeks.
• Surgery (tympanoplasty) may be needed for large tears.

A serious bacterial infection of the mastoid bone behind the ear, usually a complication of untreated otitis media.

Otoscopy Signs:

• Redness and swelling in the ear canal.
• Possible discharge.
• Pain behind the ear.

While otoscopy is primarily used to diagnose the conditions listed above, it can also help identify other ear-related issues. Some of these include:

• Foreign objects in the ear: Common in children, foreign objects can cause discomfort and potential damage to the ear canal.
• Earwax buildup: Excessive earwax can cause blockages, leading to hearing loss and discomfort.
• Ear tumours: Rare but possible, tumours can develop in the ear canal or middle ear, affecting hearing.