Diagnostic Set (Opthalmoscope /Oto-scope) (Welchallyn) – NSL – 97201

An Diagnostic Set orAuriscope是一个medical device用于查看的耳朵。Health care providers use otoscopes to screen for illness during regular check-ups and also to investigate ear symptoms. An otoscope potentially gives a view of the ear canal and tympanic membrane or eardrum. Because the eardrum is the border separating the external ear canal from the middle ear, its characteristics can be indicative of various diseases of the middle ear space. The presence of cerumen (ear wax), shed skin, pus, canal skin edema, foreign body, and various ear diseases can obscure any view of the eardrum and thus severely compromise the value of otoscopy done with a common otoscope.

最常用的耳镜由手柄和头部组成。头部包含一个光源和简单的低功率放大镜头, typically around 8乔布特（3.00倍磁）。这远端(front) end of the otoscope has an attachment for disposable plastic earspecula。审查员首先拉直耳道通过拉pinna然后将耳镜的耳朵窥镜侧插入外耳中。重要的是要用手指或小手指靠在头部上，将手握在患者头上的手握在患者头上。然后，审查员可以通过仪器后部的镜头看，看到耳道内部。在许多型号中，可以去除镜头，这使得检查员可以通过耳镜将仪器插入耳道，例如去除耳道earwax(cerumen). Most models also have an insertion point for a bulb capable of pushing air through the speculum which is calledpneumatic otoscope。This puff of air allows an examiner to test the mobility of the鼓膜膜。

医生办公室中使用的许多耳镜都是壁挂式安装的，而另一些则是便携式的。壁挂式耳镜由灵活的电源线连接到底座，在不使用时可容纳耳镜，也可以用作电力的来源，被插入电源插座。便携式模型是由电池in the handle; these batteries are usually rechargeable and can be recharged from a base unit. Otoscopes are often sold with眼镜镜as a diagnostic set.

可能由耳镜诊断的疾病包括otitis media和耳炎外部, infection of the middle and outer parts of the ear, respectively.

Otoscopes are also frequently used for examining patients’ noses (avoiding the need for a separate nasal speculum) and (with the speculum removed) upper throats.

这most commonly used otoscopes—those used in emergency rooms, pediatric offices, general practice, and by internists- are monocular devices. They provide only a two-dimensional view of the ear canal, its contents, and usually at least a portion of the eardrum, depending on what is within the ear canal and its status. Another method of performing otoscopy (visualization of the ear) is use of a binocular microscope, in conjunction with a larger metal ear speculum, with the patient supine and the head tilted, which provides a much larger field of view and the added advantages of a stable head, far superior lighting, and most importantly, depth perception. A binocular (two-eyed) view is required in order to judge depth. If wax or another material obstructs the canal and/or a view of the entire eardrum, it can easily and confidently be removed with specialized suction tips and other microscopic ear instruments, whereas the absence of depth perception with the one-eyed view of a common otoscope makes removal of anything more laborious and hazardous.

Another major advantage of the binocular microscope is that both of the examiner’s hands are free, since the microscope is suspended from a stand. The microscope has up to 40x power magnification, which allows much more detailed viewing of the entire ear canal, and of the entire eardrum unless edema of the canal skin prevents it. Subtle changes in the anatomy are much more easily detected and interpreted than with a monocular view otoscope. Traditionally only恩特specialists (otolaryngologists) and otologists (subspecialty ear doctors) acquire binocular microscopes and the necessary skills and training to use them, and incorporate their routine use in evaluating patient’s ear complaints. Studies have shown that reliance on a monocular otoscope to diagnose ear disease results in a more than 50% chance of misdiagnosis, as compared to binocular microscopic otoscopy.

这expense of acquiring a binocular microscope is only one obstacle to its being more widely adapted to general medicine. The low level of familiarity with binocular otoscopy among pediatric and general medicine professors in physician training programs is probably a more difficult obstacle to overcome. Thus, the standard of general otologic diagnosis and ear care remains, for the most part, the largely antiquated monocular otoscope.