How are ear problems diagnosed?

How are ear problems diagnosed?

According to common practice, ear problems will be diagnosed by following the common principle of assessing the patient thoroughly. This is to be done by first understanding the chief complaint (or primary concern) brought by the patient, followed by targeted clerking, exploring possible risk factors and thorough history taking in order to identify important clues that would give insights to the possible cause.

After detailed oral investigation, the patient would be required (if consent were given) to undergo physical examinations, followed by either lab test, radiological intervention or other specific evaluations according to the prerogative of the doctor, in order to deduce a well established working diagnosis and future plan for the patient.

Physical examination

Throughout a physical ear examination, a tool called an otoscope will be used to observe the outer ear canal and ear drum. Allowing the doctor to gain visual insights of the ear anatomical structure. A pneumatic otoscope (an upgraded version of the prior) will be able to incite harmless air pressure into the canal, in doing so, doctors can assess the condition of the eardrum further.

Although physical examination is commonly considered to be a part of a routinely ear related checkup, it is predominantly performed when patient complaint of having

  • hearing loss,
  • ear pain,
  • ear discharge,
  • lumps surrounding the ear
  • the sensation of having object in the ear

In short, physical examination would usually focus on assessing symptoms related to the ear canal, eardrum and the middle ear. This may include problems such as ear infections, congested earwax, damage to the eardrum, lodged objects or insects within the ear canal, and many more.

Medical laboratory test

Medical lab tests that can help in diagnosing ear related problems would include ear drainage culture test, complete blood count and other specific blood tests.

Ear drainage culture is a laboratory test that analyzes possible existence of germs (in samples taken) that can cause an infection of the ear. The sample taken can be fluids, pus, wax or blood collected from within the outer ear canal or the middle ear during surgical intervention.

Complete blood test can be proposed – in relation to an ear problem – if the patient were suspected to experience severe ear related complications such as meningitis. Other more specific medical lab tests such as anti cochlear antibody blood tests can help in diagnosing Autoimmune Inner Ear Disease or AIED.

Radiological intervention

Radiological intervention would tend to focus on diagnosing anatomical abnormalities in children, chronic ear conditions such as otosclerosis that are most prevalent amongst the senior population, severe inflammatory conditions that have spread across adjacent sinuses and causing various complications, trauma of the middle or inner ear that requires abrupt management and also ear related malignancies.

Radiological intervention of the ear usually involves x rays, CT scans, MRI and ultrasonography. However most radiological intervention and other corresponding diagnosing tools would require underlying clinical symptoms and physical evaluation that would complement each other’s findings.

Other specific evaluation

Other specific evaluation would focus on attending symptoms such as hearing problems and vestibular disorder. It is always important to realise that human vestibular organs (mostly related to body balance and coordination) lie intimately close to our hearing organs, hence the name vestibulocochlear organ. Thus hearing and vestibular problems more often than not would require conjoint assessment.

However, specifically hearing problems may be evaluated via

Typically, vestibular disorder would be evaluated through

  • Clinical test of vestibular function
  • Laboratory test of vestibular function


As a conclusion, you are advised to meet your doctor if worrying symptoms arise or whenever you feel that a comprehensive evaluation is necessary according to your schedule and priority. However problems that require immediate attention must be followed by a direct and prompt visit to the nearby hospital or clinics. This would encompass problems or symptoms such as ear bleeding, insects being stuck in the ear, sudden hearing loss and other urgent matters.

Ruth Chacon