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Otoscope
From Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/Otoscope
28-Apr-15
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The most commonly used otoscopes--those used in emergency rooms, pediatric offices, general practice,
and by internists- are monocular devices. They provide only a two dimensional view of the ear canal, its
contents, and usually at least a portion of the eardrum, depending on what is within the ear canal and its
status. Another method of performing otoscopy (visualization of the ear) is use of a binocular
microscope, in conjunction with a larger metal ear speculum, with the patient supine and the head tilted,
which provides a much larger field of view and the added advantages of a stable head, far superior
lighting, and most importantly, depth perception. A binocular (two-eyed) view is required in order to
judge depth. If wax or other material obstructs the canal and/or a view of the entire eardrum, it can
easily and confidently be removed with specialized suction tips and other microscopic ear instruments,
whereas the absence of depth perception with the one-eyed view of a common otoscope makes removal
of anything more laborious and hazardous. Another major advantage of the binocular microscope is that
both of the examiner's hands are free, since the microscope is suspended from a stand. The microscope
has up to 40x power magnification, which allows much more detailed viewing of the entire ear canal,
and of the entire eardrum, unless edema of the canal skin prevents it. Subtle changes in the anatomy are
much more easily detected and interpreted than with a monocular view otoscope. Traditionally only
ENT specialists (otolaryngologists) and otologists (subspecialty ear doctors) acquire binocular
microscopes and the necessary skills and training to use them, and incorporate their routine use in
evaluating patient's ear complaints. Studies have shown that reliance on a monocular otoscope to
diagnose ear disease results in a more than 50% chance of misdiagnosis, as compared to binocular
microscopic otoscopy. The expense of acquiring a binocular microscope is only one obstacle to its being
more widely adapted to general medicine. The low level of familiarity with binocular otoscopy among
pediatric and general medicine professors in physician training programs is probably a more difficult
obstacle to overcome. Thus the standard of general otologic diagnosis and ear care remains for the most
part the largely antiquated monocular otoscope.
External links
An article detailing the use of otoscopes
(http://web.archive.org/web/20110708075047/http://archive.student.bmj.com/back_issues/0795/7otos.htm) from one of the first issues of the Student BMJ available online published in July 1995.
This archived version
(http://web.archive.org/web/20070321073959/http://www.comdis.wisc.edu/staff/mrchial/howotoscope.ht
of a similar page from wisc.edu contains images.
This archived page from indstate.edu
(http://web.archive.org/web/20070204052853/http://web.indstate.edu/thcme/PSP/eLabs/otoscope.htm)
gives another overview with images.
Phisick (http://www.phisick.com/zent.htm#diag) Pictures and information about antique otoscopes
Retrieved from "http://en.wikipedia.org/w/index.php?title=Otoscope&oldid=648222559"
Categories: Ear procedures Medical equipment
http://en.wikipedia.org/wiki/Otoscope
28-Apr-15
Page 3 of 3
http://en.wikipedia.org/wiki/Otoscope
28-Apr-15