![]() Remember, if you have forgotten something important, you can go back and complete this. For sensorineural hearing loss, the sound is loudest on the contralateral side to the hearing deficit.For conductive hearing loss, the sound is loudest on the ipsilateral side to the hearing deficit.For normal hearing, the sound is heard in the midline.Ask the patient whether the sound is heard in the midline or has lateralised Strike the tuning fork (512Hz) against your elbow and place on the patient’s forehead in the midline. For conductive hearing loss, bone conduction is heard better than air conduction (Rinne negative).For normal hearing or sensorineural hearing loss, air conduction is heard better than bone conduction (Rinne positive).Strike the tuning fork (512Hz) against your elbow and place against the mastoid process (bone conduction), then once patient stops hearing it, hold it near the external ear canal (air conduction) *The cone of light can be used to orientate it is located in the 5 o’clock position when viewing a normal right tympanic membrane and in the 7 o’clock position for a normal left tympanic membrane.įigure 3 – A traumatic perforation of the left tympanic membrane Hold the otoscope like a pen between thumb and index finger, left hand for left ear and right hand for right ear, resting your little finger on the patient’s cheek – this acts as a pivot.įor a normal tympanic membrane, you should be able to observe*: Gently straighten out the ear canal by pulling the external ear superiorly and posteriorly Inspect the outer aspect of the external ear canal using the otoscope as a light source ![]() Figure 1 – A basal cell carcinoma located on the posterior aspect of the outer ear ![]()
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