Hartmann Ear Speculum — Medium for Myringotomy Access

Hartmann Ear Speculum — Medium for Myringotomy Access

The medium Hartmann ear speculum is the size that allows working instruments through the speculum bore: the myringotomy knife, the grommet trial, and the alligator forceps for grommet insertion. A small Hartmann lets the operator see the tympanic membrane but the aperture is too narrow to pass even a Storz myringotomy blade without obscuring the field. The medium aperture admits the working instrument and still leaves room for the surgeon’s eye on the membrane.

The myringotomy and grommet sequence

Speculum placed → tympanic membrane wax cleared → field illuminated → myringotomy made at the antero-inferior quadrant (the quadrant farthest from the ossicular chain and the chorda tympani) → middle-ear effusion suctioned → grommet trial through alligator forceps → grommet inserted across the myringotomy edge → speculum withdrawn. The medium Hartmann is the speculum on which this sequence depends.

Pairing

Used with the operating microscope under general anaesthetic in paediatric cases, or with the head-mirror under local anaesthetic in cooperative adults.