Letters to the Editor
Diagnosis and Treatment of Otitis Media
Am Fam Physician. 2008 Jul 1;78(1):28-30.
Original Article: Diagnosis and Treatment of Otitis Media
Issue Date: December 1, 2007
Available at: http://www.aafp.org/afp/20071201/1650.html
to the editor: The cover illustration on the December 1, 2007, issue of AFP unfortunately demonstrates poor technique in the use of the otoscope to examine the child's external ear canal and tympanic membrane. As illustrated, the technique risks irritation and injury to the external ear canal from the tip of the otoscope speculum if the child moves her head toward the examiner. The examiner should apply a small amount of traction to the ear lobe with the right hand to straighten the external canal. The otoscope should be held in the left hand with the fifth finger stabilizing it against the head to maintain proper position when the child moves her head, as they almost always do. The hands should be switched when examining the right ear, but stabilizing the instrument against the child's head is mandatory.
I have seen too many students, residents, and nurse practitioners examine children's ears using the technique illustrated on the cover and on the first page of this article. I would conclude that they are not being taught how to use an otoscope safely and correctly. Certainly a high quality journal such as AFP that is being read by thousands of physicians should not compound this problem.
Author disclosure: Nothing to disclose.
editor's note: Dr. Markman's critique of the inappropriate ear examination technique depicted in the December 1, 2007, cover illustration was echoed by several other readers. We agree that in this case artistic license should not have been taken with an important examination maneuver and we apologize for the oversight.
Send letters to firstname.lastname@example.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.
Copyright © 2008 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions