The lecture has been given on Oct. 11th, 2010 by Dr. Muaid.

1. Physical examination By DR. MuaidI. Aziz FICMS Otolaryngologist - head & neck surgeon

2. Physical examination History Examination Investigations

3. History Deafness Discharge Pain Itching Tinnitus vertigo

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

7. Itching

8. otalgia origin

10. Types

12. Clinical examination Inspection Palpation Otoscopic examination Microscopic examination Hearing assessment Other ENT parts assessment Cranial nerves assessment

13. Inspection

14. Otoscopic examination

15. Otoscopy External ear

16. TMtt Normal tm

17. TM state

18. Perforated TM

19. Hearing assessment Rinnesweber

20. Cranial nerves assessments

21. Investigations Audiometric 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.

24. thanks