Question
How can you tell if an ear canal is going to collapse?
Answer
While you can’t always be certain if an ear canal will collapse beforehand, I will put some light pressure on the pinnae as I am getting ready to do my otoscopic exam, before beginning pure tone testing. I look to see if the ear canal is remaining open or patent, or if I see some collapse. I can see if it is very loose and flaccid and if with just a little pressure from my hand it becomes a very narrow slit. Infants and older people are more susceptible to collapsed canals. Many audiologists use insert earphones during pure tone testing, which will alleviate the problem.
As you become more experienced with diagnostic testing, you will develop insights as to when your collective test results do not look right, and may point to signs of a collapsed canal. For example, you may find an air-bone gap on your audiogram, with normal immittance testing and a case history with no red flags of a middle ear condition. In this case, you may go back and repeat the testing to see if that air-bone gap was the result of a collapsed canal.
Editor’s note: This Ask the Expert was taken from the recorded course, Pure Tone Testing and Audiogram Interpretation presented by Dr. L. Maureen Valente. To view the course in its entirety, please register here.
