Abstract
Objective: Otoscopic examination can be carried out by using four main methods. These include otoscopic examinations made with head mirror, auriscope, otomicroscope and video-endoscope. We aimed to compare four otoscopic examination methods with respect to their accuracies in identification of pathologies and normal structures in external ear canal and tympanic membrane.
Methods: Our study involved 99 patients and their 151 ears. According to the gold standard parameters, we calculated sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the otoscopic examination methods in determining otoscopic diagnostic parameters.
Results: in determining 16 main and 77 sub-parameters which were in otoscopic examination form with four different methods, although head mirror method was insufficient in %43.8, handle otoscopy was in %25, otomicroscopy was in %12.5 of 16 main parameters, otoscopic examination with video-endoscopy was determined all of 16 main parameters.
Conclusions: Our results indicate that otoscopy with video-endoscope is superior to the other 3 examination modalities with respect to identification of external ear canal, tympanic membrane and normal or pathologic structures in these locations. Otomicroscopy seems to be the most trustworthy method after video-endoscopy. Even though auriscope is a better diagnostic tool than head mirror, it is not enough for recognition of many anatomic structures.

Key words: examination; diagnosis; endoscopy; microscopy; otoscopy