Otorhinolaryngology/ENT - Proper Examination of Ear | High Yield Points

Otorhinolaryngology/ENT - Proper Examination of Ear | High Yield Points | Drchetancreation Examination of the EarRetracting the pinna The meatus is S-shaped. To see the drum more clearly, therefore, the pinna is retracted backwards and outwards. The index finger may be used to hold the tragus forward.In babies younger than 12 months, gently pull the outer ear down and back. If this step of straightening the meatus accentuates the pain in someone presenting with an earache, one can be virtually certain that the diagnosis is either a furuncle or furunculosisThe OtoscopeThis is best held like a pen. In this way, the examiner’s little finger can rest on the patient’s cheek; If the patient’s head moves, the position of the ear speculum is maintained in the meatus.The chorda tympani nerve is the nerve of taste to the anterior two thirds of the tongue (excluding the circumvallate papillae), and is also the secretomotor nerve to the submandibular and sublingual salivary glands.The chorda tympani nerve usually lies behind the pars flaccida. It is not normally visible, but if the nerve is more inferior, it shows through the drum (arrow).
Referred Ear PainIf examination of the drum and meatus is normal in a patient complaining of earache, the pain is referred. Referred ear pain may be from nearby structures such as the temporo-mandibular joint, neck muscles, or cervical spine. It may also be from the teeth, tongue, tonsils,or larynx. Cranial nerves V, IX, and X which supply these sites have their respective tympanic and auricular branches supplying the ear. Earache also frequently precedes a Bell’s palsy.