• Examination of the tympanic membranes and ear canals is part of routine health maintenance.
• Tympanic membranes should also be visualized with complaint of ear pain, upper respiratory tract infection, or fever.
• Serial examinations are indicated over several months to check for resolution of effusion.
• A complaint of hearing loss should also prompt a careful otoscopic examination.
• In the presence of otitis externa, the tympanic membrane will be difficult to visualize because of occlusion with pus.
• Presence of cerumen in the canal may require removal with a curette or irrigation in the office or alternatively use of a cerumen-reducing agent at home with return for reexamination in a few days.
• While most offices have disposable tips for the otoscope, use of the tips supplied by the manufacturer tend to have a better fit and yield more accurate results on pneumatic otoscopy.
• A 10-mL syringe with a cut-off angiocatheter plastic tip is useful for instillation of dilute hydrogen peroxide when irrigation is required.