(1) unarmed examination method:
Pulling the auricle and the ear screen, so that the external auditory canal is straightened. Because the external auditory canal is not a straight line, but a slightly S-shaped curve, consisting of the outer 1/3 cartilaginous part and the inner 2/3 bony part, in which the direction of the outer section is inward, backward and upward, and the direction of the inner section turns inward, forward and downward. Newborns are in the shape of a slit, the direction of the external auditory canal of young children inward, forward, downward, so the examination of the external auditory canal and tympanic membrane must be supplemented by a certain maneuver to straighten the external auditory canal, in order to facilitate the examination.
①Two-handed inspection method: the inspector gently pulls the auricle backward, upward and outward with one hand to straighten the external auditory canal; the index finger of the other hand pushes the ear screen forward to expand the mouth of the external auditory canal so as to see the deeper part of the external auditory canal and the tympanic membrane.
②One-handed inspection method: If the examiner's right hand to operate (such as swabbing pus, clamping cerumen, foreign objects, etc.), the left hand pulling the auricle for inspection. When checking the left ear, the left hand from the auricle below the thumb and middle finger to hold and pull the auricle, the index finger forward to push the ear screen; checking the right ear, the left hand from the auricle above the auricle with the same method of pulling the auricle, push pressure on the ear screen, you can see the external auditory canal and the tympanic membrane.
③Infants and young children should be examined by pulling the auricle backward and downward, and at the same time pushing the ear screen forward to straighten and enlarge the external auditory canal.
(2) otoscopic examination method:
①Ear speculum examination method: the speculum is shaped like a funnel, the caliber of different sizes. When checking, should be based on the width of the external auditory canal to choose the appropriate caliber of the otoscope. The examiner's left hand pulls the auricle to make the external auditory canal straight, the right hand will be gently set into the external auditory canal, the direction of entry should be consistent with the longitudinal axis of the external auditory canal, the purpose is to overwhelm the ear hairs. Because the speculum can only see a part of the tympanic membrane, the speculum should not exceed the outer 1/3 of the external auditory canal, in order to facilitate the up and down, left and right movement, in order to see the full picture of the tympanic membrane; at the same time, it can also be avoided due to the placement of too deep compression of the bone, causing pain and coughing. If the operation is skilled, in the inspection of the left ear, the middle finger of the left hand to push the auricle upward, back, outside, the left hand index finger and thumb holding the speculum inserted into the external auditory canal, leaving the right hand to operate; inspection of the right ear, the middle finger of the left hand and forefinger holding the auricle will be back, up, outside and pull, while the left hand index finger and thumb holding the speculum inserted into the external auditory canal. After the speculum is properly inserted, the frontal mirror can be used to reflect light for examination.
②Electro-otoscopy: electro-otoscopy is a light source and magnifying glass otoscope, into the external auditory canal, such as the speculum method. This method can check the naked eye can not detect the more subtle lesions, infants and young children and bedridden patients more convenient, in the lack of frontal mirror reflective light source is particularly important.
③The tympanic otoscopy method: the distal end of the funnel-shaped otoscope inserted into the external auditory canal, the proximal end of the glass with a magnifying effect of the closed. A small hole in the side of the otoscope, through a small rubber tube connected to a rubber ball. Examination of the use of frontal mirror reflected light or the light of the electric otoscope for observation, the appropriate size of the tympanic otoscope placed in the external auditory canal, pay attention to make the otoscope and the external auditory canal skin tight, and then through repeated extrusion - relaxation of the rubber bulb, in the external auditory canal alternately produce positive and negative pressure, while observing the tympanic membrane to the inward and outward mobility. The tympanic membrane mobility decreases or disappears in the case of tympanic effusion or tympanic membrane perforation, and is significantly enhanced in the case of abnormal opening of the Eustachian tube. Tympanic otoscopy can also find small, general otoscopic perforations can not be found, through the negative pressure suction effect can also make the general examination can not see the pus from the small perforations to the outward flow. In addition, can also be used to drum gas otoscope to check the mobility of the stapes foot plate, the labyrinth with or without fistula, as well as the tympanic membrane massage and other treatments.
In addition, there are tympanic microscope, surgical microscope and flexible fiber endoscopy can observe the tympanic membrane of the various subtle changes in a more detailed way, and video archiving. Electric tympanoscopy can observe various lesions within the tympanic chamber.
The average cost for an adult to have an ear canal reconstruction is around 20,000 yuan. Children belong to a special group of people, the doctor must be based on your child's age, physical condition and the degree of ear models and many other factors to develop the most suitable for your child's surgical program, so the price is not fixed, experts recommend that you had better go to a large regular hospital, let the doctor look at the specific situation, so that the operation more conducive to achieve the best results.
And the costs incurred if you want to report can be communicated with the relevant part of the cooperative medical care, now the policy is more and more humane, I believe that things will have a solution, do not be discouraged and disappointed, all the problems will be solved.
I hope to give you a healthy and smart child!