Choosing an Otoscope: A How To Guide

When I was a nurse practitioner student, purchasing an otoscope came highly recommended. As an FNP student, years upon years of examining ears were in my future. An otoscope purchase was necessary, according to my clinical instructors at least. So, I hit the internet comparing costs and products with the intention of finding the best otoscope a broke nurse practitioner student could afford. 

My search didn't last long. I was overwhelmed with options as well as the price of such a simple device. Ultimately, I decided not to buy an otoscope at the time instead having my father send me his antiquated version from medical school in the 1970's (no disposable tips on that thing).

Since my NP student days, I've learned a thing or two about otoscopes and had the experience of finally purchasing my own. If you are in the market for an otoscope, there are a few things to consider in your search. Look at the following features in evaluating your purchase.

Size 

There are two main size categories when it comes to otoscopes, pocket size and full size. Pocket otoscopes were designed to, you guessed it, be carried in the pocket of a lab coat. They are smaller and lighter weight than their full size counterparts. Often, they come with a clip so they can be secured to the outside of a pocket. Typically, they require AA batteries and don't offer an option for interchangeable heads as do full size otoscopes. 

Full size otoscopes are significantly larger and heavier than pocket size otoscopes as they are made of more durable materials. They also offer more flexibility in terms of component options.

Battery Life and Power Source

When it comes to a power source, otoscopes come in two main categories, hard wired and battery powered. Hard wired otoscopes are usually wall mounted and remain plugged into the wall. They can only be used in the area where they are installed as a cord attached to the end of the otoscope keeps it directly connected to the wall mount during use. This is handy in a busy clinic or hospital setting where free standing otoscopes tend to get lost or go missing. 

Otoscopes that are not hard wired use rechargeable batteries as a power source. They connect to a recharging station plugged into the wall but can be removed from the station making them portable. Batteries reside in the handle of the device.

There are three main types of batteries commonly used in otoscopes; lithium, NiCd, and nickel. Lithium batteries retain their charge well even when the device is not in use and remain charged for about twice as long as other battery options. NiCd batteries are the least desirable option for an otoscope. Their charging capacity is much lower than nickel and lithium batteries. NiCd batteries also weight significantly more than their counterparts. Otoscope users will pay for the convenience offered by lithium batteries. Lithium batteries tend to cost about twice as much as NiCd and nickel batteries. 

Otoscope Head

Otoscope heads are perhaps the most important feature to consider in purchasing a device. The type of head you choose will significantly impact the cost of the otoscope as well as affect its functionality. Most otoscope handles can accommodate multiple heads so you can interchange them if needed. 

Standard Otoscope Head

Standard otoscope heads are the most common type of otoscope on the market. They are affordable, practical, and should accommodate the needs of most providers. Disposable tips attach to the head via a metal groove which is not secure and can occasionally make them prone to falling off the head of the otoscope or being left stuck in the patient's ear. 

Pneumatic Otoscope Head

Pneumatic otoscopes are more antiquated than other models and they have fallen out of favor. The tips attaching to the otoscope are quite wide. Pneumatic otoscope heads are no longer common in clinics and hospitals so most facilities no longer supply tips to accommodate. It is not advisable to purchase these models. 

Macroview Otoscope Head

Macroview otoscope heads are a bit bulkier than standard models but they provide twice the view field and about 30 percent greater magnification than their standard counterparts. A focus control feature allows the provider to adjust focus based on variable ear canal lengths. Tips twist onto the head attaching via an external groove. This prevents tips from falling off easily. 

Video Otoscope Head

Most providers will not find video features necessary in their daily practice. These otoscope heads allow for a view of the ear on a monitor screen as well as provide the ability to record and capture images. The otoscope easily hooks up to a computer with a USB cable. Video otoscope heads have decreased significantly in price in recent years with newer video macroview otoscope heads currently costing about $1,200.

Light Source

There are four types of lightbulbs commonly used in otoscopes, incandescent, halogen, xenon, and LED. Incandescent lightbulbs have a relatively short lifespan and tend to become dimmer throughout the life of the bulb. Halogen lightbulbs have a longer life and a brighter glow than incandescent light bulbs. 

Xenon lightbulbs last longer than both incandescent and halogen bulbs. They also burn brighter better illuminating the ear canal. LED bulbs last longer than all other types of bulbs. They shine the brightest and generate a whitish blue color. 

Most otoscopes use halogen or xenon bulbs. LED technology is relatively new to the otoscope scene. In choosing an otoscope, don't forget to consider accessibility to the light source. How easy is it to replace an old bulb?

Cost 

Pocket otoscopes are the most affordable otoscopes on the market with pricing starting at just above $100. But, these otoscopes have limited utility and typically do not feature interchangeable heads. Full size otoscopes start at about $250. Heads and handles for full size otoscopes can be purchased separately to accommodate changing needs. An otoscope handle runs anywhere from $150 to $350 depending on the type. Standard otoscope heads begin around the $100 price range while macroview otoscope heads cost about $225 and up. 

In choosing the perfect otoscope for your practice, think about how and when you plan to use your otoscope. Cost, the type of otoscope head, and functionality are the most important variables to keep in mind. The type of light source, for example, is not as important. Select the most practical option for your anticipated needs. A low cost handle and standard otoscope head will be sufficient to meet the needs of most nurse practitioners. 

Which type of otoscope do you like best? NP students- do you find it necessary to purchase an otoscope?

 

You Might Also Like: The Anatomy of a Stethoscope 

 

 

Comments

I have been contemplating buying one. I am not an NP at the moment. I am doing an LVN-BSN bridge. I work in LTC and find them useful when doing assessments. I am looking for a pocket type (I carry everything in my pockets). I have actually came across a few for about $40 on Amazon. I am leery, being that my thoughts were that they were really expensive. Hmm.

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