What are the steps of otoscopy?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

For optimal viewing of the tympanic membrane in an adult, retract the auricle posteriorly and superiorly to straighten the EAC; for optimal viewing in a child, pull the auricle posteriorly. Remove any debris or cerumen to allow an adequate examination. Proceed with the examination as follows:

  • First, examine the EAC for masses, skin changes, and otorrhea
  • Next, examine all parts of the tympanic membrane (eg, pars tensa and pars flaccida)
  • Next, assess the motion of the tympanic membrane by means of pneumatic otoscopy
  • Finally, attempt a thorough examination of the middle ear contents through the tympanic membrane, though this examination may be limited by the opacity of the membrane itself

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