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What does one do about VO speculum hygiene?

As with standard otoscope specula, VO specula should not be reused from patient to patient without appropriate sterilization. Pre-sterilized, disposable specula are one possible answer. If specula are to be reused, ultrasonic cleaning can be employed to remove particulate matter, such as cerumen or desquamation, from the speculum exterior and interior. However, an additional sterilization step may be required to control for microbial transmission. This may involve soaking for a prescribed length of time in an appropriate anti-microbial solution. Check with you local medical or dental supply company for a specific recommendation.

If there is evidence of external ear infection or if effusion is noted in either canal, specula should be replaced between examination of the two ears. The otoscope rod can be cleaned with alcohol wipes as the lens structure is not amenable to immersion sterilization.

How does one deal with VO lens fogging?

When humidity levels are 50% or greater, the change from room temperature (around 68 degrees F.) to ear canal temperature (around 98.6 degrees F.) can cause condensation on the rod lens surface. Four solutions have been offered, so far. Others are welcome.

  • At least one manufacturer (Starkey) has incorporated the use of a fishtank pump, originally described here in 1997, into the Siegle system for defogging.

  • VO endoscopic heads with built-in Siegle bulbs will de-fog rapidly with a few gentle air puffs, in situ. Warn the patient in advance to avoid a startle reflex.

  • Some VO system manufacturers recommend application of a pre-packaged alcohol wipe to the rod lens just prior to examination. This tends to inhibit formation of condensation.

  • In lieu fo the above, I have found it helpful to keep a very low wattage lamp at the VO stand to keep the VO rod temperature closer to that encountered in the ear.