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At least 37 records · Page 2Linked to original sources
PubMed1984

Assessing middle ear disease: beyond visual otoscopy.

Visual otoscopy, the first step in the diagnosis of middle ear conditions, permits an assessment based on the color and appearance of the tympanic membrane. With pneumatic otoscopy, the mobility of the tympanic membrane can be evaluated. Several other techniques can be used to augment visual and pneumatic otoscopy. Impedance tympanometry provides an objective record of tympanic membrane movement. The acoustic otoscope evaluates middle ear contents by the reflectivity of sound from the tympanic membrane.

Acoustic Impedance Tests↗
PubMed1980

Correlation between micro-otoscopy, micropneumatoscopy and otoadmittance tympanometry.

The micro-otoscopic, audiometric and tympanometric findings were correlated in 204 ears seen in a Veterans Administration Hospital ear clinic. Otoscopy, audiometry and tympanometry were done during the same clinical visits. In most cases pneumo-otoscopy with the microscope also was performed. Because we were unable to standardize pressures, we found pneumo-otoscopy of limited value. The data in this series were analyzed from two different points of view to determine the accuracy of the tympanometer in detecting and identifying ear disease. First the otoscopic results were compared with the tympanometric findings. Second, the procedure was reversed and various tympanometric findings were compared to the otologic diagnosis. Otophotographs were obtained in many of the ears to record findings. An otologic evaluation consists in physical and functional examinations and is not complete without both elements. It is important to remember that the tympanogram does not measure hearing loss. Tympanic membrane abnormalities can invalidate measurements of acoustic impedance and lead to a false interpretation of tympanometric findings.

Acoustic Impedance Tests↗
PubMedDate not supplied

Comparison of tympanometry and otoscopy in establishing pass/fail referral criteria.

Impedance tests, pure tone screening, and pneumatic otoscopy were performed on two groups of children. For the second group, two physicians, one an otolaryngologist and the other a pediatrician, performed the otoscopic examination. Agreement between tympanometry and otoscopy was not influenced by the presence or absence of acoustic reflexes or passing or failing the pure tone screening, but did depend on the criteria used in classifying the tympanograms. Tympanograms classified as having significant negative pressure were those showing the poorest agreement between tympanometry and otoscopy. Between examiners, agreement in otoscopic findings was generally poor. Results are discussed as they apply to establishing pass/fail criteria for screening with impedance.

Auscultation↗
PubMed1978

Pneumatic otoscopy and impedance studies in middle ear diagnosis.

The direct inspection of the tympanic membrane and its movement with Siegle pneumatic otoscopy through the binocular microscope and the electroacoustic measurements of impedance at the tympanic membrane give valuable information in the diagnosis of tympanic membrane and middle ear disorders. Problems such as otosclerosis and tympanosclerosis with ossicular chain fixation, ossicular discontinuities, ossicular chain prosthesis defects and perilymph fistulas, and the problems of middle ear fluid can be identified and differentiated. Frequently a precise diagnosis can be determined prior to surgical exploration. The use of these instruments enables the otologist to anticipate surgical findings and plan a specific procedure, thereby avoiding operative surprises. The routine use of the pneumatic otoscope and an electroacoustic impedance bridge is recommended in every case of suspected tympanic membrane or middle ear disorder, particularly where an operation is being considered. The combined information obtained through use of the two diagnostic techniques is almost always greater than that obtained by either instrument alone. Pressure recordings were made in a series of examinations with the pneumatic otoscope using the ear microscope. These pressures, both positive and negative, are acceptable and well within the range utilized by clinical electroacoustic impedance bridges. Contraindications to the use of pneumatic otoscopy and the electroacoustic impedance bridge are discussed.

Acoustic Impedance Tests↗
PubMed1988

Presumed reduction of acute ossicular subluxation by pneumatic otoscopy. Tympanometric evidence.

A 19-year-old college student sustained an otologic injury by striking the side of his face on water after diving off a 5-meter platform. Tympanometry performed immediately after the injury revealed a high-compliance notched tracing that reverted to normal after pneumatic otoscopy. Relevant experimental data on notched tracings in surgically induced ossicular discontinuity is reviewed. This case likely represents ossicular subluxation possibly related to previous otologic trauma and reduced during pneumatic otoscopy.

Acoustic Impedance Tests↗
PubMed1989

Pneumatic otoscopy: study of inter-observer variability.

The degree of inter-observer variability in the results of pneumatic otoscopy, used to predict the presence or absence of middle ear effusion was assessed. A group of 114 patients with 209 suitable ears had pneumatic otoscopy using a Seigle's speculum performed independently by two observers. The results were compared to the findings at myringotomy, on the basis that mobility of the tympanic membrane was indicative of a dry middle ear. The observers agreed in 187 ears, a concordance rate of 91 per cent, and in 174 of these (93 per cent) the observers' prediction of middle ear state was correct. The overall predictive accuracy of observer A was 89 per cent and of observer B 84 per cent, this difference is not statistically significant, p greater than 0.05.

Child↗
PubMed2000

[Virtual otoscopy--technique, indications and initial experiences with multislice spiral CT].

UNLABELLED: We report the standardized postprocessing of high-resolution CT data acquired by incremental CT and multi-slice CT in patients with suspected middle ear disorders to generate three-dimensional endoluminal views known as virtual otoscopy. MATERIALS AND METHODS: Subsequent to the definition of a postprocessing protocol, standardized endoluminal views of the middle ear were generated according to their otological relevance. The HRCT data sets of 26 ENT patients were transferred to a workstation and postprocessed to 52 virtual otoscopies. RESULTS: Generation of predefined endoluminal views from the HRCT data sets was possible in all patients. Virtual endoscopic views added meaningful information to the primary cross-sectional data in patients suffering from ossicular pathology, having contraindications for invasive tympanic endoscopy or being assessed for surgery of the tympanic cavity. Multi slice CT improved the visualization of subtle anatomic details such as the stapes suprastructure and reduced the scanning time. CONCLUSION: Virtual endoscopy allows for the non invasive endoluminal visualization of various tympanic lesions. Use of the multi-slice CT technique reduces the scanning time and improves image quality in terms of detail resolution.

Adolescent↗
PubMed1989

Pneumatic otoscopy in the diagnosis of middle ear effusion: the use of video as a teaching aid.

A recent survey has shown that the average general practitioner could expect to see 40 episodes of middle ear effusion in one year. It is an important condition because of its frequency, its insidious onset, and its persistence. It is presently associated with hearing loss, resulting in educational and social disadvantages. A more accurate diagnosis can be made over other conventional methods by the use of pneumatic otoscopy. It is a technique that is not widely used by general practitioners in this country. A videotape was produced to demonstrate the behaviour of the normal and abnormal eardrum during pneumatic otoscopy. This paper gives a review of how this was achieved.

Child↗
PubMed1998

Role of pneumatic otoscopy in the evaluation of tympanic membrane and middle ear diseases.

Many middle ear diseases show visible changes on the tympanic membrane which can be identified with pneumatic otoscopy. With practice and patience the technique can be easily performed even on infants and very young children and can reveal what may guide therapeutic approach. Careful positioning of the patient and proper insertion of a fitting ear speculum are of paramount importance. Mobility of the tympanic membrane may be absent in certain conditions and decreased or increased in other conditions. White masses are sometimes observed in the tympanic membrane or in the middle ear. These may be normal bony structures, tympanosclerosis or cholesteatoma and pneumatic otoscopy may help differentiate these conditions.

Age Factors↗
PubMed1988

Persistent effusion following acute otitis media: tympanometry and pneumatic otoscopy in diagnosis.

Children aged six months to 10 years in one practice who were diagnosed with acute otitis media were examined one, three, six and 12 months after diagnosis by a general practitioner and an otolaryngologist on the same day using pneumatic otoscopy. Tympanometry and pure tone audimetry were also carried out. Tympanograms were combined with the specialist's otoscopy findings to determine whether effusion was present. The outcome categories three months or longer after diagnosis were compared with the otoscopic findings up to that stage.The tympanometry results showed that of the 29 children (31 affected ears), five had evidence of middle ear effusion on all occasions tested, while six were normal throughout, 10 fluctuated and eight followed a resolving pattern. Examination 10-14 days or one month after diagnosis was 75% accurate in predicting effusion after three months. Recommendations are made for the use of the pneumatic otoscope in follow up by general practitioners.

Acoustic Impedance Tests↗
PubMed1979

Pediatric otoscopy and photography of the tympanic membrane.

A further miniaturization of the lens telescopes (Hopkins Rod) has resulted in a telescope (length, 6 cm; diameter, 2.7 mm) that is suitable for pediatric otoscopy. The adaptation of otoscopic specula, a lightweight motor-driven remote flash camera, and movie and video photography to this telescope has resulted in a system that represents a significant advance in the examination of the ear. In this study, we document ear diseases in children with the use of color photographs.

Child↗
PubMed1986

Adequate illumination for otoscopy. Variations due to power source, bulb, and head and speculum design.

To determine the working condition of otoscopes used in our community to diagnose middle-ear disease in children, we examined 221 otoscopes located in a hospital clinic, four emergency rooms, and the private offices of 96 physicians. The light output of each unit was measured in "as is" condition and then remeasured after a new lamp and, when possible, a new battery had been placed in the unit. A light output of 100 foot-candles or more was judged optimal for clinical otoscopy. Replacement of the bulb was significantly more likely than replacement of the battery to restore adequate light output to those units with initially poor performance (80% vs 26%). Almost one third of physicians reported changing otoscope bulbs less often than every two years, and several did not know how to replace the bulb. Almost half of the 93 rechargeable nickel-cadmium batteries inspected were outdated, but even these "expired" batteries provided adequate power when fully charged. Office otoscopes should be maintained properly to ensure optimal performance.

Evaluation Studies as Topic↗
PubMed2001

Uses and indications for video-otoscopy in small animal practice.

Acute and chronic otitis externa and otitis media are common disorders in dogs and cats. In combination with other diagnostic and therapeutic procedures, the video-otoscope is a useful and effective tool in the management of clinical cases. The enhanced illumination and magnification provide the practitioner with more detailed information for diagnosis and prognosis, and the configuration of the working channel facilitates sampling, improves efficacy of cleaning procedures, and decreases risks of iatrogenic injury to structures of the middle and inner ear. Photographic documentation of clinical cases enhances the medical record, communication with colleagues, and client education. Although video-otoscopy facilitates diagnosis and therapy, it does not replace other important diagnostic tests such as evaluation for atopy, adverse food reactions, and immune-compromising disease. Failure to identify the underlying primary cause usually results in treatment failure regardless of the technology employed.

Animals↗
PubMed2002

[Pneumatic otoscopy in pediatrics].

Pneumatic otoscopy is based upon the reaction of the tympanic membrane after sending a small air volume. A normal mobility means that air is present in the middle ear. Instead absent or reduced mobility means that effusion is present. This technique improves the quality of ears clinical examination and is particularly useful for the diagnosis of suppurative and serous otitis media.

Child↗
PubMed1985

Otoscopy, rhinoscopy, and bronchoscopy in small animal clinics.

Otoscopy, rhinoscopy, and bronchoscopy are indispensable techniwues in ear, nose, and throat clinics and in diseases of the trachea and the bronchial tree. The quality of the instruments used in these techniques is of primary importance. The endoscopic procedures, the instruments used, and the indications for the examinations are discussed.

Animals↗
PubMed1997

Duration and recurrence of otitis media with effusion in children from birth to 3 years: prospective study using monthly otoscopy and tympanometry.

OBJECTIVE: To monitor the natural course of otitis media with effusion. DESIGN: Prospective, longitudinal assessment of the state of the middle ear by otoscopy and tympanometry at monthly intervals from birth to 3 years. SETTING: Domiciliary visits to family homes. SUBJECTS: 95 full term infants born between August 1991 and November 1993. MAIN OUTCOME MEASURES: Observed and simulated data (Monte Carlo) for the duration of single episodes of otitis media with effusion. RESULTS: 17 of the children had unilateral or bilateral otitis media with effusion for more than half of their first three years of life. Thirty three of the 95 children had tympanograms suggestive of otitis media with effusion at more than a third of observations; the remaining 62 had such tympanograms at less than a third of observations. The data of each group were described by a first order Markov model, yielding a mean duration of unilateral effusion episodes of 5-6 weeks in both groups; the mean duration of bilateral effusion was 6 and 10 weeks in the low and high incidence groups, respectively. However, the main difference between the groups was the time spent between episodes of effusion: effusion free periods were, on average, three times longer in the children who experienced less otitis media with effusion. CONCLUSION: Children who are susceptible to otitis media with effusion tend to have more separate episodes of effusion rather than an increased overall duration of episodes. Such children are primarily distinguished by the likelihood with which they acquire the disease than by their ability to recover from it.

Acoustic Impedance Tests↗
PubMed1987

Quantitation of pneumatic otoscopy.

Pneumatic otoscopy has long been espoused as an easily and rapidly used, inexpensive method for routine evaluation of the tympanic membrane and middle ear. This widely used technique, however, has not been explored in a quantitative manner. Therefore, we measured the differential pressure and frequency of the pressure pulse used by a group of experienced otoscopists during routine pneumatic otoscopic examination. We found the pressure pulse varied from 170 to 520 mm H2O and the frequency varied from 2.2 to 4.9 pulses per second. We used a pneumatic pump to deliver a controlled pressure pulse--at a frequency of 4.0/sec--to the pneumatic otoscope. This device was used to measure the minimum pressure pulse necessary for the experienced otoscopist to merely detect tympanic membrane movement in normal ears. The threshold for visible movement ranged from 10 to 15 mm H2O. Thus, even the most gentle otoscopist used a pressure pulse an order of magnitude higher than the threshold for detection of visible movement in normal ears. The gap between the pressure pulse at threshold for visual detection of movement and that which is routinely used offers the possibility of increased sensitivity and specificity for this commonly used diagnostic tool. Preliminary data are presented from this study in which the pressure pulses required for visual detection of tympanic membrane movement in diseased ears were determined.

Ear Diseases↗
PubMed1984

Otoscopy and tympanometry in screening for middle ear disorders in children.

In this study tympanometry and otoscopy were conducted in 893 children in Kuwait. Otoscopic examination revealed pathologic findings in 41.7%, while 30.6% had type B or C tympanograms. Based on referral criteria commonly used in tympanometry 31% of the children should be referred for further evaluation. Using the combined otoscopic and tympanometric evaluation of the ears the referral rate could be reduced to 18%.

Acoustic Impedance Tests↗