The 4.5mm size is ideal for adults and bigger children, with the 2.5mm better for infants. They can be hygienically cleaned and reused.
The speculum inner surface has a low-reflectance black texture, while the outer surface is smooth to aid cleaning and easy insertion. To avoid canal wall irritation the tips are rounded. The loupe provides a clear magnified view such that when the tip of the speculum is placed just past the hairs in the canal the drum is comfortably in focus.
The ’pencil’ style grip is probably the most straightforward and intuitive grip, and it gives a high degree of control. The side of the hand or the little, ring, and middle fingers can comfortably rest on the subjects face providing support.
Should there be a sudden and unexpected jerk especially towards you, then the subject’s head and the whole hand/instrument will move together, greatly minimising risk of trauma.
The ’hammer’ style grip is preferred by some. Again support from the little, ring, and middle fingers tensed and resting on the face provide stability and operational safety.
With adults it is usually necessary to straighten the ear canal to enable a clear view of the drum. To do this: firmly grip upper edge of the pinna and pull gently back and upwards.
Remember to view the actual drum rather than just the canal wall: aim slightly downwards and forwards in an imaginary line towards the angle of the jaw on the opposite side of the face.