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problem-focused history
holding the child
equipment
cleaning ear
tympanic membrane
(with
practice exercises)
anatomy of the TM
tympanometry
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How to use the examination equipment
| Pneumatic Otoscope |
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The hand-held pneumatic otoscope provides mobility for the examiner in the exam room, allowing the exam to be completed wherever the child, parent, and examiner
are comfortable.
Notice the way the physician cradles the pneumatic bulb in the web space between his thumb and index finger, freeing up his other hand.
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| Use the pneumatic otoscope for all examinations for suspected acute otitis media, and attempt to observe movement of the tympanic membrane on all exams. |
| Tele-otoscope |
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This is the tele-otoscope which we use for research. It takes a detailed color photo of the ear canal and tympanic membrane. We have taken photographs of tympanic membranes of children down to age 3 months, using a 3 mm speculum.
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| Specula - 3, 4 and 5 mm |
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These are 3, 4, and 5 mm specula. A 3 mm speculum is about as small as you can comfortably use, and still get a large enough view of the tympanic membrane.
We use 3 mm specula extensively in children from birth to age 3 years. Children age 1-3 years can often accommodate 4 or 5 mm specula.
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| These specula are slightly rounded at the tip, preventing damage to the ear canal when inserted tightly to facilitate a pneumatic seal. Sometimes we
use 2 mm specula if the ear canal is very narrow, or in very young babies, or if it is necessary to look through a small opening between lumps of cerumen. |
Binocular Head Light
Photo of the binocular head light. We use it most for cerumen removal.
We see about 25 patients a day, working with at least one medical student each day.
We use the headlight for cerumen removal 4 or 5 times per day, on average.
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| Disposable Ear Curettes
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Clean, new, plastic disposable ear curettes are used. The older metal curettes needed to be sterilized between patients. AIDS and hepatitis B are particularly dangerous
infections that could be transmitted by unclean instruments.
The top, blue one, is our favorite, because it is shaped like a tiny spoon. We tell the child that it is an ear spoon, and let the child hold it while we are getting ready, to
defuse any anxiety.
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