P K A 8 7 O p e r a t i o n a l M a n u a l
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Identify the pars tensa with its cone of light, the handle and short
process of malleus, and the anterior and posterior folds of the pars
flaccida and position of the malleus handle..
Examination of the ear canal and tympanic membrane
The ear canal and tympanic membrane should then be examined. This may
not be possible in all cases, for example, due to the absence of an ear canal, due to
the presence of bandaging or when doing so might cause pain or undue discomfort.
Particular care should be taken if the subject has recently undergone ear surgery,
might not remain still during examination or is anxious about
undergoing the procedure.
The ear canal and tympanic membrane should be examined using a device that
provides appropriate magnification and illumination, has been produced for the
purpose of ear examination and meets relevant safety standards, referred to
hereafter as an „otoscope‟. An otoscope that employs a separate viewing screen
instead of a built-in viewfinder, such as a computer monitor, will be referred to as a
„video otoscope‟. Before use, the examiner shall ensure the otoscope is
operational and that any relevant safety checks have been conducted.
The examiner shall adopt a stable position when examining the ear using an
otoscope. This involves the examiner taking necessary precautions to minimize the
risk of harming the subject, or her/himself, through the loss of balance for example.
For example, the examiner should not stand bent-over.
To start, the examiner shall select an appropriately sized speculum, based on the
initial examination of the entrance to the ear canal and the need to obtain adequate
illumination. This speculum shall then be securely, and hygienically, attached to the
otoscope. The otoscope shall be held by the examiner in such a way as to enable
secure bracin
g against the subject‟s head in order to avoid injuring the ear if, for
instance, the subject makes a sudden movement. The upper rows of Figures
illustrate examples of safe practice for otoscope.
The examiner shall then carefully guide the tip of the speculum (attached to the
otoscope) into the ear canal while observing the ear (not necessarily through the
viewfinder of the otoscope).
