《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）Ear_2、Ear Examination

Otology3:SpiralganglionofCorti4:SpiralorganofCortiMiddle esr and external ear

Otology

Examination of the ear. The auricle,external auditory canal and thepostaural region are thoroughly inspectedfor the shape and size of the auriclecolorchanges in the skin,swelling,ulcer or aprevious operativescar

Examination of the ear • The auricle,external auditory canal and the postaural region are thoroughly inspected for the shape and size of the auricle,color changes in the skin,swelling,ulcer or a previous operative scar

Methods of examination of the earConventionalapproachOtoscopyExamination withsiegel's speculumExaminationundermicroscope

Methods of examination of the ear • Conventional approach • Otoscopy • Examination with siegel's speculum • Examination under microscope

ConventionalaapproachThe inside of the external canal is examined convenientlyusingaheadmirror,light sourceandanear speculum双手检查法图1-3-158.器m

• Conventional approach • The inside of the external canal is examined conveniently using a head mirror,light source and an ear speculum

让，以免引起疼痛（图1-3-3%图1-3-3双手耳镜检查法图1-3-4单手耳镜检查法

.OtoscopyThe otoscope gives some magnification and isuseful in examination children and infants.and forbedside examination of the patients,but anymanipulation with an instrument while using theotoscopeisimpossible

• Otoscopy The otoscope gives some magnification and is useful in examination children and infants,and for bedside examination of the patients,but any manipulation with an instrument while using the otoscope is impossible

.Examination with siegel's speculumThis speculumconsistsofa 10 diopterlens andasidetubeconnectedwitha rubberbulb.Anair tight system is produced in thecanal and pressure inincreasedinthebulb.Thespeculumishelpfulforthefollowingreasons1.Itgives amagnified view of themembrane2.It is helpful to assess the mobility of the membrane3.The speculum is used to elicit the fistula sign 4.By varying the pressure,discharge through theperforationcanbesucked outaswellasmedication canbeput into themiddle ear图1-3-5枝气耳锁检盗法

• Examination with siegel's speculum This speculum consists of a 10 diopter lens and a side tube connected with a rubber bulb.An air tight system is produced in the canal and pressure in increased in the bulb. The speculum is helpful for the following reasons. • 1.It gives a magnified view of the membrane. • 2.It is helpful to assess the mobility of the membrane. • 3.The speculum is used to elicit the fistula sign. • 4.By varying the pressure,discharge through the perforation can be sucked out as well as medication can be put into the middle ear. •

·Examinationundermicroscope. For better and detailed examination of the middleearcleft,examinationundermicroscopeisofgreathelpFig.5.1Examination underthe microsope

• Examination under microscope • For better and detailed examination of the middle ear cleft,examination under microscope is of great help

ExaminationoftheeustachiantubeExamination of eustachian tube function.and thusof middle-ear pressure,is an important part of theexamination oftheearValsalva's Test The patient keeps the nostrils tightlypinched and attempts toblowout: air enters the eustachiantube.The eardrum is seen to move,and a click is oftenheard. The test is useful to know the mobility of theeardrum as well as the patency of the eustachian tube.Thistestmaynormallybenegative

Examination of the eustachian tube • Examination of eustachian tube function,and thus of middle-ear pressure,is an important part of the examination of the ear. • Valsalva's Test The patient keeps the nostrils tightly pinched and attempts to blowout; air enters the eustachian tube.The eardrum is seen to move,and a click is often heard. The test is useful to know the mobility of the eardrum as well as the patency of the eustachian tube. This test may normally be negative

PolitzerzationPolizer's method consists of applying the olive of a Polizerbag firmly to one nostril and pinching the other side.Thepatient blows the cheeks and the bag is suddenly pressed toforce air up the eustachian tube.The outward movement of theeardrum indicates apatent eustachian tube微头橡皮球B

• Politzerzation Polizer's method consists of applying the olive of a Polizer bag firmly to one nostril and pinching the other side.The patient blows the cheeks and the bag is suddenly pressed to force air up the eustachian tube.The outward movement of the eardrum indicates a patent eustachian tube