How To Do An External Auditory Canal Examination At Home
How to do external auditory canal examination at home by otoscope?
First, the examinee sat sideways with the ear facing the examiner; the examiner projected the focus of the front of the otoscope reflection to the external auditory meatus orifice of the examinee. When adjusting the focal length, the inspector can move his head forward and backward, so that the brightest spot can be projected on the inspected part. For pediatric patients, parents should be instructed to hold their side on their thighs, and clamp their legs with both thighs, fix their head with one hand, and wrap their arms around their upper body for examination. Commonly used inspection methods are:
(1) Bare-handed examination at home:
Draw the auricle and tragus to straighten the external auditory canal. Because the external auditory canal is not straight, but slightly S-shaped bending, consisting of the outer 1/3 cartilage and the inner 2/3 bone, in which the outer segment is inward, backward and upward, and the inner segment is inward, forward and downward. Neonates are cracked, and the direction of the external auditory canal is inward, forward and downward. Therefore, the examination of the external auditory canal and tympanic membranes must be accompanied by certain techniques to straighten the external auditory canal in order to facilitate the examination.
① Both Hands examination at home: The examiner gently pulls the auricle backward, upward and outward with one hand to straighten the external auditory canal, and pushes the tragus forward with the other index finger to enlarge the orifice of the external auditory canal so as to see the deep part of the external auditory canal and the tympanic membrane.
② One-handed examination at home: If the examiner needs to operate on his right hand (such as cleaning pus, forceps to take out cerumen, foreign body, etc.), he will pull the auricle with his left hand for examination. When examining the left ear, the left hand holds and pulls the auricle from the lower part of the auricle with the thumb and middle finger, and pushes the tragus forward with the forefinger; when examining the right ear, the left hand pulls the auricle from the upper part of the auricle in the same way and pushes the tragus, so that the external auditory canal and the tympanic membrane can be seen clearly.
③ When examining infants, the auricle should be pulled back and down, and the tragus should be pushed forward so as to make the external auditory canal straight and enlarged.
(2)Use otoscope at home:
①Examination of otoscope: The shape of otoscope is funnel and the caliber is different. During the examination, the appropriate diameter otoscope should be selected according to the width of the external auditory canal. The examiner straightens the external auditory canal by pulling the auricle with his left hand and gently inserts the otoscope into the external auditory canal with his right hand in the same direction as the longitudinal axis of the external auditory canal in order to overwhelm the hair of the ear. Because only a part of the tympanic membrane can be seen through the ear-peeper, the ear-peeper should not exceed the outer 1/3 of the external auditory canal, so that it can move up and down to observe the whole tympanic membrane. At the same time, it can avoid the pain and cough caused by too deep compression of the bone. If the operation is skilled, push the auricle upward, backward and outward with the middle finger of the left hand, insert the peeper into the external auditory canal with the index finger and thumb of the left hand, and open the right hand. When the right ear is examined, the middle finger and index finger of the left hand hold the auricle backward, upward and outward, and the peeper is inserted with the index finger and thumb of the left hand. Into the external auditory canal. After the ear peeper is inserted properly, the frontal mirror reflection light can be used for examination.
②Use digital otoscope for home: It is an ear mirror with a light source and magnifying glass. It is also used as an ear-peeper when it is placed into the external auditory canal. This method can detect more subtle lesions which can not be detected by naked eyes. It is more convenient for infants and bedridden patients, especially in areas where there is no reflective light source of frontal mirror.
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