(1) unarmed inspection method:
Pull the auricle and tragus to straighten the external auditory canal. Because the external auditory canal is not straight, but slightly S-shaped, it consists of external 1/3 cartilage and internal 2/3 bone, in which the external segment is inward, backward and upward, and the internal segment is inward, forward and downward. The newborn is fissure-shaped, and the direction of children's external auditory canal is inward, forward and downward. Therefore, when examining the external auditory canal and tympanic membrane, we must supplement certain techniques to straighten the external auditory canal, which is beneficial to the examination.
① Double-hand examination: the examiner pulls the auricle backward, upward and outward with one hand to straighten the external auditory canal; Push the tragus forward with the index finger of the other hand to enlarge the opening of the external auditory canal so as to see the deep part of the external auditory canal and the tympanic membrane clearly.
② One-handed inspection method: If the inspector needs to operate with his right hand (such as scraping pus, ear wax, foreign body, etc.). ), and then pull the auricle with your left hand for inspection. When checking the left ear, the left hand pinches and pulls the auricle from below with the thumb and middle finger, and the index finger pushes the tragus forward; When examining the right ear, the left hand pulls the auricle from above the auricle in the same way and pushes the tragus to see the external auditory canal and tympanic membrane clearly.
③ When examining the baby, the auricle should be pulled backward, and the tragus should be pushed forward at the same time, so that the external auditory canal can be straightened and expanded.
(2) otoscopy:
① Inspection method of otoscope: The otoscope looks like a funnel with different diameters. The otoscope with appropriate caliber should be selected according to the width of external auditory canal. The examiner pulls the auricle with his left hand to straighten the external auditory canal, and puts the otoscope into the external auditory canal gently with his right hand, and the extension direction should be consistent with the longitudinal axis of the external auditory canal, so as to overwhelm the ear hair. Because only a part of the eardrum can be seen through the otoscope, the otoscope should not exceed the outer 1/3 of the external auditory canal, which is convenient for moving up and down, left and right to see the whole eardrum; At the same time, it can also avoid the pain and cough caused by too deep compression of the bone. If you are skilled, you can push the auricle upward, backward and outward with your left middle finger, insert the otoscope into the external auditory canal with your left index finger and thumb, and operate with your left hand. When examining the right ear, the middle finger and forefinger of the left hand hold the auricle and pull it backward, upward and outward, while the index finger and thumb of the left hand hold the otoscope and insert it into the external auditory canal. After the otoscope is inserted correctly, the light reflected by the forehead mirror can be used for inspection.
② Electric otoscope examination: Electric otoscope is an otoscope with its own light source and magnifying glass, and it is also like otoscope when put into the external auditory canal. This method can detect subtle lesions that can't be detected by naked eyes, which is more convenient for infants and bedridden patients, especially where there is no light source for frontal mirror reflection.
③ Inflatable otoscope: The funnel-shaped distal end of otoscope is inserted into the external auditory canal, and the proximal end is sealed with a glass sheet with magnifying function. A small hole is opened on the side of the otoscope, and a rubber ball is connected through a small rubber tube. Dure that examination, the light reflected by the forehead mirror or the light of the electric otoscope is use for observation, an inflated otoscope with a proper size is placed in the external auditory canal to make the otoscope close to the skin of the external auditory canal, and then positive and negative pressure are alternately generated in the external auditory canal by repeatedly squeezing-releasing the rubber ball, and at the same time, the internal and external mobility of the tympanic membrane is observed. The tympanic membrane activity is weakened or disappeared when tympanic effusion or tympanic membrane perforation occurs, and it is obviously enhanced when the eustachian tube is abnormally opened. Small perforations that can't be found under ordinary otoscope can also be found under inflated otoscope, and pus that can't be seen under ordinary examination can also flow out from small perforations through negative pressure suction. In addition, you can also use the inflatable otoscope to check the mobility of the stapedial foot plate, whether there is fistula in the maze, tympanic membrane massage and so on.
In addition, there are tympanic membrane microscopes, surgical microscopes and flexible fiber endoscopes in clinic, which can observe various subtle changes of tympanic membrane in more detail and record them through video. Electric tympanoscope can observe various pathological changes of tympanum.
The average cost of adult ear canal plastic surgery is about 20 thousand yuan. Children belong to a special group, and doctors must work out the most suitable surgical plan for your child according to many factors such as your child's age, physical condition, ear mold degree and so on, so the price is not fixed. Experts suggest that first go to a large regular hospital and let the doctor see the specific situation, which is more conducive to the operation to achieve the best results.
If you want to report the expenses incurred, you can communicate with the relevant parts of cooperative medical care. Now the policy is becoming more and more humanized. I believe everything will be solved. Don't be discouraged, all problems will be solved.
I hope I can give you a healthy and smart child!