For proper otoscopy, the external auditory canal should be cleaned. Few instruments are used for this step, namely, aural speculi of different sizes, a Billeau ear loop, Hartman auricular forceps, and suction tips ( ▶ Fig. 1.1). In cases with a history of recurrent otitis, we prefer to clean the ear with the aid of a microscope ( ▶ Fig. 1.2). Fig. 1.1 Instruments used for cleaning the external auditory canal. Fig. 1.2 Microscope used as an aid in cleaning the ear. The use of a rigid 0-degree 6-cm endoscope ( ▶ Fig. 1.3) connected to a video system enables the patient to see the pathology involving his/her ear ( ▶ Fig. 1.4). The rigid 30-degree endoscope allows evaluation of attic retraction pockets, the extent of which cannot always be determined using the microscope or the 0-degree endoscope ( ▶ Fig. 1.5). Fig. 1.3 A rigid 0-degree 6-cm endoscope.
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