An ear examination is a thorough evaluation of the ears that is done to screen for ear problems, such as hearing loss, ear pain, discharge, lumps, or objects in the ear. An ear examination can detect problems in the ear canal, eardrum, and the middle ear, such as infection, excessive earwax, or an object like a bean or a bead.

During an ear examination, an instrument called an otoscope is used to look at the outer ear canal and eardrum. An otoscope is a handheld instrument with a light, a magnifying lens, and a funnel-shaped viewing piece with a narrow, pointed end called a speculum. A pneumatic otoscope has a rubber bulb that your doctor can squeeze to give a puff of air into the ear canal. This allows the doctor to see how the eardrum moves.

Why It Is Done

An ear examination may be done:

• As part of a routine physical examination.
• To screen babies and children for hearing loss.
• To determine the cause of symptoms such as earache, a feeling of pressure or fullness in the ear, or hearing loss.
• To check for excess wax buildup or an object in the ear canal.
• To find the location of an ear infection. The infection may involve only the external ear canal (otitis externa) or the middle ear behind the eardrum (otitis media).
• To monitor the effectiveness of treatment for an ear problem.

How To Prepare

It is important to sit very still during an ear examination. A young child should be lying down with his or her head turned to the side or sitting on the lap of an adult with the child's head resting securely on the adult's chest. Older children and adults can sit with the head tilted slightly toward the opposite shoulder.

Your doctor may need to remove earwax in order to see the eardrum.

How It Is Done

An ear examination can be done in a doctor's office, a school, or the workplace.

For an ear examination, the doctor uses a special instrument called an otoscope to look into the ear canal and see the eardrum.

Your doctor will gently pull your ear back and slightly up to straighten the ear canal. If a baby under 12 months is being examined, the ear will be pulled downward and out to straighten the ear canal. The doctor will then insert the pointed end (speculum) of the otoscope into your ear and gently move the speculum through the middle of your ear canal to avoid irritating the canal lining. The doctor will look at each eardrum (tympanic membrane).

Using a pneumatic otoscope lets your doctor see what the eardrum looks like and how well it moves when the pressure inside the ear canal is changed. And it helps the doctor determine if there is a problem with the eustachian tube or fluid behind the eardrum (otitis media with effusion). A normal eardrum will flex inward and outward in response to the changes in pressure.