Basic Basic OtoscopyOtoscopy

Steven D. Rauch, MDSteven D. Rauch, MDDept. of OtolaryngologyDept. of OtolaryngologyHarvard Medical SchoolHarvard Medical School

The Massachusetts Eye & Ear InfirmaryThe Massachusetts Eye & Ear InfirmaryBoston, MABoston, MA

Basic Basic OtoscopyOtoscopy: Definition: Definition

Transmit light down the ear canal to view the Transmit light down the ear canal to view the canal wall and tympanic membrane (TM)canal wall and tympanic membrane (TM)

Observe the color, luster, and mobility of the TMObserve the color, luster, and mobility of the TM

PneumaticPneumatic OtoscopyOtoscopy::

Use Use insufflation insufflation bulb to apply positive and bulb to apply positive and negative air pressure to the TM and observe negative air pressure to the TM and observe how mobile it ishow mobile it is

Basic Basic OtoscopyOtoscopy: Anatomy: Anatomy

Basic Basic OtoscopyOtoscopy: Anatomy: Anatomy

Tympanic MembraneTympanic Membrane

Tympanic CavityTympanic Cavity

MalleusMalleusOuter EarOuter Ear

External Ear CanalExternal Ear Canal

Basic Basic OtoscopyOtoscopy: Normal TM: Normal TM

LandmarksLandmarks

AnnulusAnnulus

Lateral process of Lateral process of malleusmalleus

UmboUmbo

Light reflexLight reflex

Basic Basic OtoscopyOtoscopy: Normal TM: Normal TM

LandmarksLandmarks

AnnulusAnnulus

Lateral process of Lateral process of malleusmalleus

UmboUmbo

Light reflexLight reflex

Basic Basic OtoscopyOtoscopy: Normal TM: Normal TM

LandmarksLandmarks

AnnulusAnnulus

Lateral process of Lateral process of malleusmalleus

UmboUmbo

Light reflexLight reflex

Basic Basic OtoscopyOtoscopy: Normal TM: Normal TM

LandmarksLandmarks

AnnulusAnnulus

Lateral process of Lateral process of malleusmalleus

UmboUmbo

Light reflexLight reflex

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

Traumatic perforationTraumatic perforation

BloodBlood

Visible hole in TMVisible hole in TM

Absent mobilityAbsent mobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

Traumatic perforationTraumatic perforation

BloodBlood

Visible hole in TMVisible hole in TM

Absent mobilityAbsent mobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

Traumatic perforationTraumatic perforation

BloodBlood

Visible hole in TMVisible hole in TM

Absent mobilityAbsent mobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

HemotympanumHemotympanum

Intact TMIntact TM

Dark red/purple airDark red/purple air--fluid level behind TMfluid level behind TM

Reduced or absent Reduced or absent mobilitymobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

HemotympanumHemotympanum

Intact TMIntact TM

Dark red/purple airDark red/purple air--fluid level behind TMfluid level behind TM

Reduced or absent Reduced or absent mobilitymobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

HemotympanumHemotympanum

Intact TMIntact TM

Dark red/purple airDark red/purple air--fluid level behind TMfluid level behind TM

Reduced or absent Reduced or absent mobilitymobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

HemotympanumHemotympanum

Intact TMIntact TM

Dark red/purple airDark red/purple air--fluid level behind TMfluid level behind TM

Reduced or absent Reduced or absent mobilitymobility

Basic Basic OtoscopyOtoscopy: Conditions : Conditions Dx’dDx’d

CSF leakCSF leak

Intact or torn TMIntact or torn TM

Clear watery airClear watery air--fluid fluid level behind TM or level behind TM or watery fluid running watery fluid running from TM from TM perfperf

Basic Basic OtoscopyOtoscopy: Practical skills: Practical skills