# EXAMINATION OF THE EAR

EXAMINATION OF THE EAR

The instruments required for examination are shown in Figure 51.5 . Examination of  the ear is part of  the general ear, nose and throat (ENT) examination. Rinne and Weber tuning fork tests are used to distinguish between a conductive and a sensorineural hearing loss. The correct way to hold an otoscope is shown in Figure 51.6 . The CNs and especially the function of  the facial nerve should be examined. Although conversational testing can give a useful guide to the level of  hearing, pure tone audiometry the best way of establishing the in a soundproof booth is air and bone hearing levels ( Figure 51.7 ). Other common audiological tests include speech audiometry , tympanometry , stapedial reflexes, electric response audiometry , otoacoustic emissions, caloric testing and electronystagmography (see Further reading ). 

Figure 51.5
Tools of the trade: a
/f_i
breoptic otoscope, with pneumatic
attachment and a selection of specula. Also a 512-Hz tuning fork.
Figure 51.6
The correct method of holding the otoscope. Note the
pinna is retracted to straighten the ear canal. Hold the barrel of
the otoscope so that the examiner’s little
/f_i
nger is balanced on the
patient’s cheek; this prevents the speculum impinging on the tym
panic membrane in case of sudden movement.

EXAMINATION OF THE EAR

The instruments required for examination are shown in Figure 51.5 . Examination of  the ear is part of  the general ear, nose and throat (ENT) examination. Rinne and Weber tuning fork tests are used to distinguish between a conductive and a sensorineural hearing loss. The correct way to hold an otoscope is shown in Figure 51.6 . The CNs and especially the function of  the facial nerve should be examined. Although conversational testing can give a useful guide to the level of  hearing, pure tone audiometry the best way of establishing the in a soundproof booth is air and bone hearing levels ( Figure 51.7 ). Other common audiological tests include speech audiometry , tympanometry , stapedial reflexes, electric response audiometry , otoacoustic emissions, caloric testing and electronystagmography (see Further reading ). 

Figure 51.5
Tools of the trade: a
/f_i
breoptic otoscope, with pneumatic
attachment and a selection of specula. Also a 512-Hz tuning fork.
Figure 51.6
The correct method of holding the otoscope. Note the
pinna is retracted to straighten the ear canal. Hold the barrel of
the otoscope so that the examiner’s little
/f_i
nger is balanced on the
patient’s cheek; this prevents the speculum impinging on the tym
panic membrane in case of sudden movement.