Professional Otoscope Auroscope with accessories from Sigma Lance

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Inspection of the eardrum can also provide a lot of information about what's happening within the middle ear – the space within the skull where the hearing and balance mechanisms are situated. Most otoscopes have a small air vent connection that allows the doctor to puff air in to the canal. Observing how much the eardrum moves with air pressure assesses its mobility, which varies depending on the pressure within the middle ear. This technique is called insufflation. The HEINE otoscopy compendium provides practical tips and gives an initial insight into typical clinical pictures.

Move in close to the patient’s eye. At around 6cms you will see a magnified view of the eyelids and front of the eye.

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By toggling through the light settings a blue light will come on which can highlight fluorescein staining of abrasions and ulcers.

Absence or distortion of the light reflex is associated with otitis media (due to bulging of the TM). Perforation By carefully advancing the speculum down into the external auditory meatus you will see the external ear canal and tympanic membrane. The otoscope should be held in your right hand for the patient’s right ear and vice versa for the left ear. Deformity of the pinnae: this may be acquired (e.g. cauliflower ear) or congenital (e.g. anotia, microtia, low-set ears). Many otoscopes used in doctors offices are wall-mounted while others are portable. Wall-mounted otoscopes are attached by a flexible power cord to a base, which serves to hold the otoscope when it's not in use and also serves as a source of electric power, being plugged into an electric outlet. Portable models are powered by batteries in the handle; these batteries are usually rechargeable and can be recharged from a base unit. Otoscopes are often sold with ophthalmoscopes as a diagnostic set.

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Retraction of the TM suggests reduced middle ear pressure, which is commonly caused by pharyngotympanic tube dysfunction secondary to upper respiratory tract infections and allergies. Light reflex