How is otitis media (middle ear infection) diagnosed?

When an ear infection is suspected, the doctor or nurse will examine the ear using an instrument called an otoscope. A healthy eardrum will be pinkish gray in color and translucent (clear). If infection is present, the eardrum may be inflamed, swollen, or red.

The doctor may also check the fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air at the eardrum. This should cause the eardrum to move back and forth. The eardrum will not move as easily if there is fluid inside the ear.

Another useful diagnostic tool is tympanometry, a test that uses sound and air pressure to check for fluid in the middle ear. (It cannot test hearing.) If needed, the doctor will order a hearing test (performed by an audiologist) for a patient who has persistent ear infections to help determine if there is any hearing loss, and how bad it is.

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