How To Pronounce Otoscopy?

To begin with, let's clarify the pronunciation of otoscopy. It is pronounced as oh-tuh-skoh-pee, with the emphasis on the first syllable. Now that we have that covered, let's explore how otoscopy is performed and who typically carries it out.

Who Performs Otoscopy & What Is It For?

Otoscopy is typically conducted by a healthcare professional such as an otolaryngologist (ear, nose, and throat specialist), a primary care physician, or an audiologist. During the procedure, the examiner uses an otoscope. The examiner gently inserts the speculum of the otoscope into the ear canal to examine the structures inside the ear.

These days video otoscopy is available. This means that the view of the scope can be projected onto a screen that can be displayed for medical or patient education. The video and still images can also be saved for future reference. Recently, handheld video otoscopy has advanced even further to be compatible with personal devices such as smartphones or tablets.

How is Otoscopy Performed?

Here is a step-by-step guide on how your healthcare professional conducts an ear examination using otoscopy:
1. Prepare the patient:
Ensure that the patient is comfortably seated or lying down. Inform them about the procedure and address any concerns they may have. Provide clear instructions and assure them that the procedure is generally painless.
2. Gather the necessary equipment:
Obtain an otoscope, which consists of a handle, an ear speculum (a cone-shaped attachment), a light source, and a magnifying lens. Ensure that the otoscope is clean and in working condition.
3. Position themself and the patient:
The healthcare professional will stand or sit facing the patient. If possible, they'll adjust the patient's head to a comfortable position, slightly tilted away from the ear being examined. This will allow better visualization of the ear canal.
4. Inspect the external ear:
They will begin by visually examining the external ear or auricle for any abnormalities such as redness, swelling, or discharge. They will also look for signs of injury, infection, or foreign objects.
5. Insert the ear speculum:
The clinician will gently grasp the ear speculum in one hand and hold it at a 30-degree angle from the vertical. With their other hand, they'll stabilize the patient's head by gently holding it. Then they will slowly and carefully insert the ear speculum into the auditory canal, to avoid applying excessive force or causing discomfort.
6. Illuminate the ear canal:
Typically, the light source on the otoscope is activated from the outset to illuminate the outer ear and ear canal. The clinician will direct the light around the ear canal while maintaining a steady hand. They'll adjust the position and angle of the otoscope as needed to ensure proper visualization.
7. Observe the ear canal and eardrum:
They'll look for any signs of inflammation, swelling, fluid buildup, earwax impaction, or foreign objects within the ear canal. They'll also examine the eardrum for color, shape, integrity, and movement.
8. Perform pneumatic otoscopy (optional):
If necessary, pneumatic otoscopy may be performed by using the insufflation bulb on the otoscope. The specialist will gently apply air pressure into the ear canal while observing the movement of the eardrum, noting any abnormalities such as reduced mobility or retraction.
9. Repeat for the other ear:
After completing the examination of one ear, the speculum is carefully removed from the ear and cleaned if needed. The process is repeated for the other ear, following the same steps.
10. Document findings:
Detailed notes of the observations, including any abnormalities, discharge, or other relevant information will be documented. The healthcare provider will record the color, position, and condition of the eardrum, and document any symptoms reported by the patient.
11. Communicate findings and recommend further steps:
Their findings will be discussed with the patient, explaining any identified conditions or concerns. If necessary,  further tests, treatment options, or referrals to specialists will be recommended.
Remember, otoscopy requires skill and practice to perform accurately. If you are not a trained healthcare professional, it is important to consult a qualified medical practitioner for proper evaluation and diagnosis of ear conditions.

Note: This step-by-step guide provides a general overview of otoscopy. The specific technique may vary depending on the healthcare professional and the equipment used.

Does Otoscopy Hurt?

One common concern people may have about otoscopy is whether it hurts. Rest assured, otoscopy is generally painless. The examiner carefully navigates the otoscope through the ear canal without causing discomfort. However, if you have any concerns or discomfort, it is important to communicate with your healthcare provider.

What Can Be Diagnosed With Otoscopy?

Otoscopy enables healthcare professionals to diagnose a wide range of ear-related conditions. Some common conditions that can be identified through otoscopy include:
1. Ear infections:
Otitis media, an infection of the middle ear, can be detected through otoscopy. The procedure allows the examiner to observe inflammation, redness, fluid buildup, or pus behind the eardrum or tympanic membrane.1
2. Eardrum abnormalities:
Otoscopy helps identify abnormalities in the tympanic membrane such as perforations (holes), scarring, or retraction.
3. Cerumen impaction:
Excessive earwax buildup can be detected during otoscopy. The procedure helps determine the extent of the impaction and whether it requires removal.
4. Foreign objects:
If an object becomes lodged in the ear canal, otoscopy allows the examiner to visualize and remove it safely.

What is Pneumatic Otoscopy?

In addition to standard otoscopy, there is a specialized technique called pneumatic otoscopy. This involves applying air pressure to the ear canal to evaluate the movement of the tympanic membrane.

Pneumatic otoscopy helps assess the functionality of the Eustachian tube, a small passage connecting the middle ear to the back of the throat. Problems with the Eustachian tube can cause issues such as fluid accumulation or middle ear effusion, hearing loss, or recurrent infections.2

Can You See the Eustachian Tube or a Cholesteatoma Via Otoscopy?

While otoscopy provides valuable information about the ear, it is important to note that it has its limitations. The Eustachian tube and cholesteatoma, an abnormal growth in the middle ear, are not directly visible through otoscopy alone.3 However, additional tests such as imaging studies or specialized procedures may be performed to further investigate and diagnose these conditions if they are suspected.


In conclusion, otoscopy is an essential diagnostic tool used to examine the ear and diagnose various conditions. Through otoscopic examination, healthcare professionals can identify ear infections, eardrum abnormalities, earwax impaction, and foreign objects. Pneumatic otoscopy aids in assessing Eustachian tube function.

Remember, otoscopy is a painless procedure, and it is typically performed by healthcare professionals such as otolaryngologists, primary care physicians, or audiologists.


  1. National Institute on Deafness and Other Communication Disorders (NIDCD). (n.d.). Ear Infections in Children. Retrieved from
  2. Pneumatic otoscopy (2021). Mayo Clinic. Retrieved from on 28 June 2023.
  3. Cholesteatoma (2022). MedlinePlus. Retrieved from on 28 June 2023.
The information contained in this article is for educational and informational purposes only. You should not use the information as a substitute for, nor should it replace, professional medical advice. If you have any questions about your health, you should always consult with a physician or other health-care professional.