Often people complain of earache, so what are the causes of earache, how to use otoscope?
External ear examination included auricle, periauricular tissue, external auditory meatus orifice, external auditory meatus bone and tympanic membrane surface examination.
1. At the beginning of the examination, prepare the otoscope, first pull the auricle and tragus, straighten the external auditory canal, widen the orifice of the ear canal, put the focus of the reflected light from the frontal mirror into the external auditory canal, aim at the walls of the external auditory canal and all parts of the tympanic membrane, or further peep through the otoscope to see the whole picture, and be patient and clear before examining the tympanic membrane or secretions.
2. Two-handed examination: Take the otoscope and examine the right ear. For those who have become old, the examiner pulls the auricle backward and upward with his left hand, presses the skin in front of the tragus with his right finger or thumb to make it forward, thus straightening the cartilage part of the curved external auditory canal and widening the orifice of the external auditory canal, so that he can peep at all parts of the external auditory canal and tympanic membrane. For infants, pull the ear down.
3. One-handed examination: when examining the right ear, the examiner pulls the auricle upward with his left thumb and middle finger, pressing the ear tray forward with his index finger, straightening the curved auditory canal, placing the appropriate ear mirror in the external auditory canal with his right hand, fixing it with his left thumb and index finger, and performing various operations with his right hand. On the contrary, when examining the left ear, the right thumb and middle finger pull the auricle backward and upward from below, and the index finger press the skin in front of the tragus forward, which widens the orifice of the external auditory canal, straightens the auditory canal and freely operates the empty left hand.
4. Infant examination method: the external auditory canal of infants is strangulated or even gapped. Its bending direction is inclined inward, forward, downward and tympanic membrane, which is about 35 degrees. Therefore, when using otoscope, the auricle should be pulled backward and downward, and the tragus should be pushed forward so as to widen and straighten the external auditory canal so that the whole picture can be seen and examined. The two sides should be compared in order to find slight lesions.
Before otoscope, patients with earache should first inquire about the nature of earache, such as jumping pain, compressive swelling pain, needle-like pain, knife-like pain, tearing pain, traction pain, etc. The pain is mild or severe and lasts for a long or short time.
There are spontaneous pain, chewing and swallowing pain, deep pain in the ear, and radiation to the ipsilateral head and neck. Attention should be paid to the characteristics of the accompanying symptoms so that proper otoscope can be performed and early diagnosis can be made.
During the otoscope inspection, attention should be paid not only to the changes in the ear and its surroundings, but also to the nasal cavity, nasopharynx, sinuses, throat, mouth and head and neck.