This document provides an overview of a physical examination for ear-related issues. It discusses examining the patient's history regarding deafness, discharge, pain, itching, tinnitus, and vertigo. It then covers clinically examining the external ear, tympanic membrane, hearing assessment using Rinne and Weber tests, and cranial nerve assessment. Finally, it discusses investigations that may be conducted including audiometric tests of pure-tone audiometry and tympanometry as well as radiographic tests of plain X-rays and CT scans of the temporal bone.

1. Physical examinationBy DR. MuaidI. AzizFICMSOtolaryngologist - head & neck surgeon

2. Physical examination HistoryExaminationInvestigations

3. HistoryDeafnessDischargePainItchingTinnitusvertigo

4. Deafness Definition TypesCHL ?SNHL?Sudden onset causes occlusion of EAM by wax or discharge

5. middle ear pathology as effusion , blast injury , perforating TM

6. vascular occlusion or viral infection affecting inner ear ( emergency) Discharge Consistency (soft wax , serous or purulent , muco purulent , frank pus (offensive or not ), bloody , watery)originDuration

7. Itching

8. otalgiaorigin

9. Tinnitus it’s a sensation of sound in the ear

10. Types

11. CausesvertigoDefinitionTrue vertigo or dizzinessPeripheral or central Main common causesMedical or rehabilitation therapy

12. Clinical examinationInspectionPalpation Otoscopic examinationMicroscopic examinationHearing assessmentOther ENT parts assessmentCranial nerves assessment

13. Inspection

14. Otoscopic examination

15. OtoscopyExternal ear

16. TMtt Normal tm

17. TM state

18. Perforated TM

19. Hearing assessmentRinnesweber

20. Cranial nerves assessments

21. InvestigationsAudiometric Tests: Includes: 1. Pure – tone Audiometry (PTA) which is most commonly used used for measuring hearing acuity. 2. Tympanometry which provides a quick objective measurement of the state of the middle ear.

22. Radiography Plain X-Ray; of the temporal bone show the degree of pneumatization of the mastoid , clouding of the air cells can indicate infection while area of erosion may be seen in cholesteatoma , malignant disease.CT-SCAN ; is now widely used specially in complicated otitis media, in revision surgery.