How do you perform a pneumatic Otoscopy?

Pneumatic otoscopy is an ear examination that assesses eardrum movement in response to pressure changes. A healthy eardrum moves in response to pressure. Immobility may be due to:

• Fluid in the ear
• Perforation (hole)
• Tympanosclerosis (scarring of the eardrum)
• Middle ear infections

Advantages of a pneumatic otoscopy include:

• High sensitivity and specificity to identify a middle ear infection
• Better than other ear examination methods
• Cheaper than other methods
• Easy to perform with appropriate training
• Quick and painless tests
• Otoscopes are widely available

A pneumatic otoscopy provides a useful means to examine diseases in the middle ear.

• Our ear has three parts. Each part has an important function:
• The outer ear (pinna and ear canal) gathers and directs sound, causing the eardrum to vibrate.
• The middle ear (tympanic membrane, ossicles, mastoid, and eustachian tube) augments and passes the vibrations to the inner ear.
• The inner ear (cochlea) transforms the vibration into electrical signals and drives them to the brain.

For a pneumatic otoscopy, you require the following:

• Pneumatic otoscopes: These are instruments used to visualize the ear canal and eardrums. Otoscopes must be fully charged with a bright bulb.
• Ear specula: These are funnel-shaped pieces of plastic attached to an otoscope. An ear speculum is inserted into the ear canal.
• Insufflator bulbs: These are attached tightly to the head of an otoscope by means of a tube.

A pneumatic otoscopy is useful to diagnose the following conditions:

• Acute otitis media (a painful type of ear infection)
• Otitis media with effusion (collection of thick fluid behind the eardrum)
• Tympanic membrane retraction (retraction of the eardrum)
• Hennebert’s sign or fistula test (a test done to identify the root cause of repeated vertigo)
• Brown’s sign (a test done to reveal a reddish-bluish pulsatile mass behind the eardrum)

You might experience slight discomfort during the procedure. Some of the less common complications of pneumatic otoscopy include:

• Ossicular discontinuity: It is the loss of normal alignment between the three middle ear bones.
• Sensorineural deafness: It is hearing loss caused by damage to the inner ear or the nerve from the ear to the brain.