Ready, Set, Peek! Your Easy Guide to Using the Deebo® Otoscope

How to perform an ear exam is covered in The Deebo® DIY Guidebook, but here are some additional tips that may help to improve your technique and view of the ear canal and ear drum.

How To Get the Best View of the Ear?

• Start with the right specula size.Each Deebo kit comes with three sizes of specula – one for babies (2mm), one for kids (3mm) and one for adults (5mm). Start with the ear speculum size that is age appropriate, but it is normal to size up - only if it fits comfortably for the child – this can help a lot with getting a better view.
• Use both hands.Using one hand, hold the otoscope like a pen and use the pinky finger to rest on the child’s face for stability. The other hand will be used to straighten the ear canal. Straightening the ear canal is vital in obtaining the best view. To straighten the ear canal in children and adults, use your other hand to gently pull the outer ear up and back.  For babies, gently pull the ear down and back.
• Point Towards the Nose – Point the otoscope down 45 degrees towards the patient’s nose.
• Have fun!Everyone loves the Deebo Otoscope is because it’s fun to use. Tell your child that you are looking for Sprinkles or Rainbows or whatever your kids are into. Tell them you are looking for red ones and blue ones.  Have fun and be creative. Both kids and parents will giggle through it all. 

What you Should See in a Healthy Ear

The Ear Canal should be the same color as the children’s normal skin tone

• Is lined with tiny hairs
  
• Could have ear wax
  

The Ear Drum is pearly white or light grey

• Is translucent; the outline of the tiny bones just behind the membrane should be visible
  
• Light should reflect off of it
  

Photo:  A normal right ear drum with clear view of the malleus (first middle ear bone) and “cone of light” 

Things To Avoid During an Exam?

• DO NOT insert the speculum to far – it should not cause pain.
• Be careful NOT to rub the sides of the ear canal with the speculum as it may be uncomfortable – try to aim for the middle of the ear canal.
• DO NOT try to look for too long – after 20 or 30 seconds, a child will likely need a break.
• DO NOT use the same ear speculum for different children – use a fresh ear speculum for each child and each exam.
• DO NOT use one hand – use your other hand to gently pull the child’s outer ear up and back and to help stabilize the head and minimize movement during the exam.
• DO NOT put anything else in the ear!  The use of Q-tips, bobby pins, tissue, etc. is not recommended for removal of ear wax or foreign bodies and can be dangerous.
• DO NOT get frustrated!  Successful ear exams take practice.  Sometimes, a good view of the ear drum is limited by ear wax.  However, ANTHING you see can be helpful information for both you and your pediatrician.
  

What are some abnormal findings you might see during an ear exam?

• Ear Infections- A red or bulging ear drum may indicate an acute infection of the middle ear or “otitis media”. A dull-appearing ear drum with no visible “cone of light” may be a sign of fluid in the middle ear
• Ear Wax - Usually, some ear wax may be visible and is normal.  In some cases, enough ear will be present to obscure your view of the ear drum.  Do not worry!  You are still gaining valuable information – for example, the presence of ear wax, the absence of any drainage, no signs of bleeding, etc.  Even these simple findings can be helpful information for both you and your pediatrician.  
• Ear Tubes – These are placed in the ear by an ENT Surgeon. Using an otoscope can helpful to keep an eye on them to ensure they are not blocked or fallen out prematurely.
• Swimmer’s Ear - Drainage or whitish debris in the ear canal may be a sign of infection of the skin of the ear canal or “otitis externa”.  A common term for this kind of infection is swimmer’s ear.
• Foreign Objects - Children have been known to put strange things in their ears such as beads, small rocks, popcorn kernels, and many others.  If you find a foreign body, do not attempt removal on your own and let your pediatrician or ENT doctor know immediately.