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Definition

What is an ear exam?

An ear examination is an inspection of the ear canal and eardrum using an instrument called an otoscope. An otoscope is a handheld instrument with a light, magnifying glass, and a funnel-shaped viewing platform with a narrow, pointed tip called a speculum.

An ear exam can help detect many ear problems, such as ear infections, excessive earwax, or objects in the ear canal. This examination can also be done independently at home.

After receiving instructions and training from a doctor, a self-examination of the ear can be useful for parents of young children who often develop ear infections and earaches. The child may occasionally have an ear infection whose outward symptoms may be irritability, fever, or tugging at the ear.

An ear exam may help find the cause of ear symptoms. However, it can be difficult to learn to use an otoscope, and some otoscopes are poor quality.

Why is an ear examination done?

Ear exams can be done to:

• This is part of the physical examination
• Check for hearing loss in infants and children
• Look for the cause of symptoms, such as earache, ear fullness, or hearing loss
• Seeing signs of infection when people have earaches or young children have vague symptoms
• Check for insects in the ear, or other foreign objects
• Check earwax buildup if people complain of hearing loss or ear congestion or compression
• Check if the treatments for ear problems are working properly

Quoted from the National Center for Biotechnology Information, conditions that require you to undergo an ear exam include:

• Otalgia (ear pain)
• Otorrhea (discharge from the ear)
• Vertigo
• Tinnitus
• Hearing disorders
• Weakness of the facial muscles

Preparation

What are the preparations before doing an ear examination?

No special preparation is required before taking this test. Always remember to clean the ear speculum with warm, soapy water before using it. This ear examination may feel uncomfortable.

It is important to remember that you should sit still during the examination. Young children need to be lying on the adult's thigh or placed in a quiet position on the adult's chest.

Your doctor may need to remove your earwax to view the eardrums.

Process

How is the ear examination process?

Here are the steps for a general ear examination:

• The doctor asks you or your child to sit or lie down
• The doctor will gently pull the ear back and slightly upward to straighten the ear canal
• The doctor inserts the pointed end (speculum) of the otoscope into the ear
• The speculum is gently moved through the middle of the ear canal to avoid irritation
• The doctor will check the eardrum (tympanic membrane)

The doctor will look at the condition of the eardrum with an otoscope. It can also show how well the eardrum moves when the pressure inside the ear canal changes.

This can help the doctor see if there is a problem with the eustachian tube or fluid behind the eardrum. A normal eardrum will curve in and out in response to changes in pressure.

Examination of the ear using an otoscope is usually painless. If you have an ear infection, it will cause a little pain in the ear canal.

Risk

What are the risks that might occur due to this examination?

Michigan Medicine says the pointed tip of the otoscope can irritate the lining of the ear canal. This can be avoided by inserting the otoscope slowly and carefully.

If the otoscope erodes the lining of the ear canal, it can cause bleeding or infection. However, this condition is rare.

Test results

What do my test results mean?

An ear examination with otoscopy provides information about the condition of your ear canals and eardrums. The ENT doctor will explain the results of this examination to you. Here's the explanation:

Ear canal

Here are the test results for normal and abnormal ear canals:

Normal

• Ear canals vary in size, shape and color.
• The ear canal is skin-colored and contains fine hair and usually a certain amount of earwax is yellowish-brown or reddish brown.

Abnormal

• There is pain when the outer ear is pulled or shaken.
• The ear canal is red, tender, swollen, or filled with pus.

Eardrum

Here are the test results for normal and abnormal eardrums:

Normal

• Eardrums are pearly white or light gray.
• There is a small bone in the middle ear that pushes against the eardrum.
• There is a cone-shaped light, called "light reflex", reflecting off the surface of the eardrum. The light cone is in the 5 o'clock position on the right ear and 7 o'clock on the left ear.

Abnormal

• The light that bounces off the eardrum looks faded or absent.
• The eardrums are red and bulging.
• There is a yellow bubble or fluid behind the eardrum, a hole in the eardrum (perforation), and white scarring on the surface of the eardrum.

If you are having your ear checked at home, you will need to contact your doctor when you notice any of the following symptoms:

• Inflamed or suppurating ducts
• Eardrums that are faded or reddish in color
• There is fluid behind the eardrum
• There is a hole in the eardrum, or a foreign object in the ear

What does it mean if the test results are abnormal?

Dull or absent light reflection from the eardrum may be a sign of infection or fluid in the middle ear. Ear infections are a common problem, especially in children.

Abnormal results can also be caused by an external ear infection. You may feel pain when the outer ear is pulled or moved.

This examination can also be done to detect other ear disorders, such as:

• Cholesteatoma
• Chronic outer ear infection
• Head injury
• The eardrum burst

Follow-up

How to deal with abnormal otoscope results?

When the results of the ear examination show abnormalities, the doctor will recommend treatment depending on the cause. Not only that, your doctor may advise you to do further tests. Here's the explanation:

Treatment

Ear infections usually go away on their own, without any medication. However, the US Centers for Disease Control and Prevention, the CDC, say that antibiotics, such as amoxicillin, may be needed to treat serious cases or when symptoms persist within 2-3 days.

Further examination

Please note, not all ear disorders can be detected through the otoscope. Ear and hearing tests may be needed for a variety of other ear conditions.

Other tests your doctor may need to diagnose your condition include:

• Acoustic immittance testing, which is a test to see if the middle ear is receiving sound.
• Vestibular test, which is an examination to look for problems in the middle ear area that regulates balance and coordination.
• MRI and CT scans to test the inner ear in preparation for surgery, such as cochlear implants.