Examination of the ear takes place often and in diverse circumstances. In cure-focused primary care, it will be carried out in a GP practice and in secondary care the ear examination will mainly be carried out in the ENT surgery practice, but also in paediatric, neurology and internal medicine practices. In social and preventative healthcare the examination of the ear also forms part of the examination protocols. During the ear examination a patient is examined for any structural abnormalities and/or damage to the anatomical structures of the ear that may give rise to or lead to symptoms. This is done primarily through inspection. Palpation plays a minor role in the examination of the ear.
What is your prediagnosis and what will you ask the patient?
Prediagnosis
Congenital abnormalities
Inflammation
Tumours
Vascular problems
Trauma
Degenerative disorders of the:
– auricle or pinna
– auditory meatus
– middle ear
– inner ear
Allergy
In the history-taking the following should be explored:
- What is the precise nature of the complaints?
- How old is the patient?
- How long has the symptom been present?
- What has the course of the complaint been since it started?
- How did the complaint start, suddenly or gradually?
- Are there any factors that worsen or improve the complaint?
- Does the patient have fever and if so, what is their temperature?
- Is one or are both ears affected?
- Does the patient have or has the patient had a cold?
- Has the patient or their parents already attempted to do something about the complaint and what was the outcome of this?
- Does the patient suffer from dizziness?
- Is the hearing affected?