=Methods and Technic of Examination.=—The external ear may be examined
by direct inspection with or without the aid of artificial light.
The external auditory meatus may be examined by means of a simple
conical ear speculum and reflected light from a head mirror. This
method requires considerable practice but efficiency can and should be
attained because it can be used under all conditions and therefore is a
reliable method.
The Holmes electric auroscope which we use and recommend for examining
the meatus and ear drum, is very efficient but like other electrical
equipment is not always dependable. There are many electrical
equipments for examining the ear, but so far I have found none other
than the one above mentioned that is worth space in an instrument
cabinet.
To examine the meatus, grasp the pinna and draw it firmly upward and
backward. This tends to straighten the canal so that the aural speculum
may be inserted well into the external canal. It must be remembered
that the auditory canal is always sensitive and while there is really
little danger of doing any harm by exercising ordinary care, the
patient is always afraid of being hurt and one can accomplish better
results by practicing careful technic.
If the electric auroscope is used, the eye should be placed very close
to the lens and every part of the canal, walls and drum membrane
carefully examined. The Holmes auroscope has a small tube and bulb,
pressure upon which will vary the air pressure in the meatus and cause
the drum to move. This must be done very carefully because in very
thin, atrophic membranes there is some danger of rupturing the drum.