Using an otoscope First explain to the patient that you are going to look in the ear and that it may be uncomfortable, although it should not be painful. Choose a speculum size that is appropriate for the patient's canals and fit it to the otoscope. Children have narrower canals and will require a narrower speculum than adults. Always hold the otoscope in the hand of the same side as the ear you are about to examine. You can hold the otoscope in either a pencil grip or a hammer grip.
Many students prefer the hammer grip as it initially feels more natural.
It is less satisfactory, however, because you have less control, which increases the risk of inflicting pain by pressing the speculum tip on to the skin of the canal wall. We recommend that you persevere with the pencil grip until you find it a more natural poise. Examine the good ear first Examine the good ear first. With the light source turned up full, use the otoscope as a torch to examine the pinna briefly for meatal abnormalities and previous surgical wounds. The commonest scars around the ear are those from postaural and endaural incisions.