Otoscope Grip Preference

A pediatrician shows a Wispr otoscope image to their emergency physician colleague. The emergency physician is initially confused by the image. Why does the image initially seem confusing to the emergency physician? The pediatrician is holding the otoscope differently. Generally speaking, the otoscope orientation that pediatricians use is 180 degrees different from non-pediatric physicians. The orientation of the saved image is dependent on the orientation in which the otoscope was held. These exam photos demonstrate the difference in the resulting ear image. The image is rotated 180 degrees corresponding to the grip used on the digital Wispr otoscope. Once the orientation of the otoscope is taken into account, it is a simple matter to mentally rotate the image such that the malleus always points “upward.” Pediatricians are trained to use the superior orientation of the otoscope as it is thought to give better control in the case of a squirmy patient. In both orientations, the examiner should stabilize the otoscope position with fingers such that a sudden movement of the patient’s head does not cause undesired movement of the otoscope. Here are videos of the two otoscopy techniques: