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ophthalmoscope | otoscope | otoscopy
ophthalmoscope | otoscope | otoscopy
The otoscope (from the Greek οὖς, gen. ὠτός "ear" and σκοπέω "to look at") is a device used by ENT doctors and hearing aid acousticians to examine and examine the external auditory canal, including the eardrum (otoscopy). Otoscopy can be used to diagnose diseases (otitis externa), foreign bodies or parasitic infestations of the external auditory canal, and changes to the eardrum. It is usually carried out by ENT doctors as the first examination for hearing problems.
Hearing aid acousticians use it to assess the structures of the external ear in order to be able to produce appropriate earmolds for hearing aids.
Hearing aid acousticians use it to assess the structures of the external ear in order to be able to produce appropriate earmolds for hearing aids.
Story
The otoscope replaced the ear specula that had been described since the 14th century. The French military doctor Jean-Pierre Bonnafont invented it in the first half of the 19th century, but was unable to make his invention known. The ear funnels of various sizes that are commonly used today and are attached to otoscopes were the ear funnels developed by Anton von Tröltsch around 1860.
The concave mirror with a central viewing hole developed by Tröltsch has a focal length that corresponds to the spatial conditions of the external auditory canal. The instrument, which is usually worn on the headband, together with an ear funnel, makes it easier to examine the auditory canal and eardrum in reflected light and opens up new possibilities for diagnosing ear diseases. Until then, catheterization of the Eustachian tube and auscultation as well as inspection of the auditory canal in direct light were the main methods used. Along with the stethoscope, the otoscope has been a frequently used symbol of the medical profession for over a hundred years.
Tröltsch's lasting achievement is that, with the help of the examination methods he improved, he was able to make the results of new pathological-anatomical research, which he also actively pursued, fruitful for practical implementation in diagnostics and nosology. Together with Hermann Schwartze in Halle (Saale), who was more active in surgery, and Adam Politzer in Vienna, who was known for developing new therapeutic methods, Tröltsch is one of the founders of modern otolaryngology in German-speaking countries. He laid the foundations for researching ear diseases using scientific methods and for otolaryngology to be recognized as an independent surgical discipline. At a time when, for example, ear infections were still very often not recognized or treated with inadequate methods and, as a result, chronic hearing loss and hearing impairment in all age groups were the predominant diseases in the patient population of an otolaryngologist, the new diagnostic and therapeutic methods quickly proved their usefulness and quickly became widespread.
Tröltsch's teaching and publishing activities had a major influence on the further development of the field, in particular his textbook on ear diseases and his co-founding and co-editing, together with Schwartze and Politzer, of the specialist journal Archiv für Ohrenheilkunde. The textbook appeared in a total of seven editions up to 1881 and was translated into English in 1864 (The surgical diseases of the ear) and into French in 1870 by his student Abraham Kuhn (Traité pratique des maladies de l'oreille). The archive is still published today, since 2004 under the title European archives of oto-rhino-laryngology and head & neck (ISSN 0937-4477). Several university professors and founders of university ear clinics are Tröltsch's students, including Friedrich Bezold in Munich, Kurd Bürkner in Göttingen, Abraham Kuhn in Strasbourg, Dagobert Schwabach in Berlin, Josef Georg Wagenhäuser in Tübingen and his successor in Würzburg, Wilhelm Kirchner.
Two pocket-like anatomical structures on the eardrum first described by Tröltsch are named after him: Recessus anterior membranae tympanicae and Recessus posterior membranae tympanicae are also called anterior and posterior Tröltsch's pockets. The knee-shaped hook forceps he developed for manipulation in the external auditory canal are still manufactured and used unchanged today and also bear his name.
The German Society for Otorhinolaryngology, Head and Neck Surgery awards the Anton von Tröltsch Prize for outstanding scientific achievements in the field of otorhinolaryngology. © wikipedia
The concave mirror with a central viewing hole developed by Tröltsch has a focal length that corresponds to the spatial conditions of the external auditory canal. The instrument, which is usually worn on the headband, together with an ear funnel, makes it easier to examine the auditory canal and eardrum in reflected light and opens up new possibilities for diagnosing ear diseases. Until then, catheterization of the Eustachian tube and auscultation as well as inspection of the auditory canal in direct light were the main methods used. Along with the stethoscope, the otoscope has been a frequently used symbol of the medical profession for over a hundred years.
Tröltsch's lasting achievement is that, with the help of the examination methods he improved, he was able to make the results of new pathological-anatomical research, which he also actively pursued, fruitful for practical implementation in diagnostics and nosology. Together with Hermann Schwartze in Halle (Saale), who was more active in surgery, and Adam Politzer in Vienna, who was known for developing new therapeutic methods, Tröltsch is one of the founders of modern otolaryngology in German-speaking countries. He laid the foundations for researching ear diseases using scientific methods and for otolaryngology to be recognized as an independent surgical discipline. At a time when, for example, ear infections were still very often not recognized or treated with inadequate methods and, as a result, chronic hearing loss and hearing impairment in all age groups were the predominant diseases in the patient population of an otolaryngologist, the new diagnostic and therapeutic methods quickly proved their usefulness and quickly became widespread.
Tröltsch's teaching and publishing activities had a major influence on the further development of the field, in particular his textbook on ear diseases and his co-founding and co-editing, together with Schwartze and Politzer, of the specialist journal Archiv für Ohrenheilkunde. The textbook appeared in a total of seven editions up to 1881 and was translated into English in 1864 (The surgical diseases of the ear) and into French in 1870 by his student Abraham Kuhn (Traité pratique des maladies de l'oreille). The archive is still published today, since 2004 under the title European archives of oto-rhino-laryngology and head & neck (ISSN 0937-4477). Several university professors and founders of university ear clinics are Tröltsch's students, including Friedrich Bezold in Munich, Kurd Bürkner in Göttingen, Abraham Kuhn in Strasbourg, Dagobert Schwabach in Berlin, Josef Georg Wagenhäuser in Tübingen and his successor in Würzburg, Wilhelm Kirchner.
Two pocket-like anatomical structures on the eardrum first described by Tröltsch are named after him: Recessus anterior membranae tympanicae and Recessus posterior membranae tympanicae are also called anterior and posterior Tröltsch's pockets. The knee-shaped hook forceps he developed for manipulation in the external auditory canal are still manufactured and used unchanged today and also bear his name.
The German Society for Otorhinolaryngology, Head and Neck Surgery awards the Anton von Tröltsch Prize for outstanding scientific achievements in the field of otorhinolaryngology. © wikipedia
The otoscope today
Today's otoscope is not much different from the well-known ear speculum. Today it consists of a handle that contains a battery or accumulator, the light source and an ear funnel that is inserted into the ear. The energy source provides the bright light required for otoscopy. The lighting can be either a xenon halogen lamp or often LED lighting. Modern LED lighting requires much less power than halogen lamps and is significantly more durable than these lamps.
The otoscope head can be equipped with either direct lighting (lamp shines directly through the funnel) or with so-called fiber optics (FO). With fiber optics, the light from the lamp is guided into the funnel via glass fibers that serve as light guides, which enables uninterrupted vision through the funnel.
The otoscope head can be equipped with either direct lighting (lamp shines directly through the funnel) or with so-called fiber optics (FO). With fiber optics, the light from the lamp is guided into the funnel via glass fibers that serve as light guides, which enables uninterrupted vision through the funnel.
Das Ophthalmoskop
An ophthalmoscope is a medical instrument used to examine the interior of the eye, particularly the retina, optic disc, and blood vessels. It consists of a light source, magnifying lenses, and various apertures or filters to enhance visibility. Ophthalmologists and general practitioners use ophthalmoscopes to detect retinal diseases, glaucoma, optic nerve abnormalities, and diabetic retinopathy.
There are two main types of ophthalmoscopes:
- Direct ophthalmoscope: Provides a magnified, upright image of the retina and is commonly used in general practice.
- Indirect ophthalmoscope: Offers a wider field of view and a more detailed image, often used by specialists.
History of the Ophthalmoscope
The ophthalmoscope was invented in 1851 by Hermann von Helmholtz, a German physicist and physiologist. His invention revolutionized ophthalmology by allowing direct examination of the retina and optic nerve. Helmholtz's original design used a simple system of mirrors and a light source to illuminate the inside of the eye while minimizing reflections.
Over time, the ophthalmoscope has undergone significant advancements. Modern devices, such as the Heine BETA 200 and BETA 200S LED, incorporate aspheric optics, selectable apertures, and LED technology to improve diagnostic precision. LED lighting provides consistent illumination, a longer lifespan, and better visibility for eye examinations.
An Ophthalmoskop Today
Modern ophthalmoscopes have evolved with technological innovations that enhance diagnostic accuracy and ease of use. Key advancements include:
- LED Technology: Long-lasting, high-performance LEDs provide consistent brightness, superior color rendering, and no heat generation.
- Aspheric Optics: Reduces glare and reflections, improving visibility of the retina.
- Selectable Apertures: Many modern models, such as the Heine BETA 200S LED, feature six different aperture options, allowing physicians to tailor examinations to specific diagnostic needs.
- Ergonomic Design: Lightweight and compact models provide better handling, even during prolonged examinations.
- Wireless and Rechargeable Systems: Many modern ophthalmoscopes feature rechargeable battery systems for greater mobility and convenience.
Among leading modern ophthalmoscopes, Heine's BETA 200 LED and BETA 200S LED stand out for their optical precision, durability, and innovative technology. Their LED HQ illumination and selectable apertures ensure high-quality, detailed eye examinations.