ENT History Taking and Examination

History Taking

The following issues should be included:

  • Classic symptoms of ear disease: deafness, tinnitus, discharge (otorrhoea), pain (otalgia) and vertigo.
  • Previous ear surgery, or head injury.
  • Family history of deafness.
  • Systemic disease (eg, stroke, multiple sclerosis, cardiovascular disease).
  • Ototoxic drugs (antibiotics (eg, gentamicin), diuretics, cytotoxics).
  • Exposure to noise (eg, pneumatic drill or shooting).
  • History of atopy and allergy in children.

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Inspecting the external ear

Inspect the external ear before examination with an otoscope/auriscope. Swab any discharge and remove any wax. Look for obvious signs of abnormality.

  • Size and shape of the pinna.
  • Extra cartilage tags/pre-auricular sinuses or pits.
  • Signs of trauma to the pinna.
  • Suspicious skin lesions on the pinna, including neoplasia.
  • Skin conditions of the pinna and external canal.
  • Infection/inflammation of the external ear canal, with discharge.
  • Signs/scars of previous surgery.

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