Use of a Teaching Pneumatic Otoscope

To the Editor.—  Conventional instruction in otoscopy relies on sequential observations of the tympanic membrane by instructor and student. This method is beset with difficulties, including discomfort for the patient, trauma to the external auditory canal, and the inability of the instructor to be sure that the student is seeing the structures described. Particularly difficult to teach with conventional methods is the skill of pneumatic otoscopy. Students must learn the response of the tympanic membrane to varying pressures of air. This mode of sequential examination trains students poorly; interobserver differences are great.¹ Teaching operating microscopes used by otolaryngologists obviate these difficulties, but such devices are large, expensive, and usually unavailable in a pediatric clinic or office.At our request, a teaching pneumatic otoscope was designed and manufactured by Welch-Allyn Inc, Skaneateles Falls, NY (Figure). Two viewing ports allow examination simultaneously by two observers. The instructor can demonstrate specific structures,