Role of pneumatic otoscopy in the evaluation of tympanic membrane and middle ear diseases.

Many middle ear diseases show visible changes on the tympanic membrane which can be identified with pneumatic otoscopy. With practice and patience the technique can be easily performed even on infants and very young children and can reveal what may guide therapeutic approach. Careful positioning of the patient and proper insertion of a fitting ear speculum are of paramount importance. Mobility of the tympanic membrane may be absent in certain conditions and decreased or increased in other conditions. White masses are sometimes observed in the tympanic membrane or in the middle ear. These may be normal bony structures, tympanosclerosis or cholesteatoma and pneumatic otoscopy may help differentiate these conditions.