1<br > In evaluating otologic hmction， a close<br >The Otologic Evaluation work.，g ， e~at~onsh~p between the physi-<br > cian and audiologist is essential. Each con-<br > tributes relatively unique expertise， but the<br >Brnce W. Jafek ohservations shouhl be complementary; the<br > best resuhs are obtained if each nnder-<br >Dennis V. Barcz stands the working diagm)sis and hypothe-<br > sis of tbe otber， Immediate consultation<br > should take place， possibly followed by re-<br > examination or joint examination in ~om-<br > plex cases or in those in which the results<br > are unclear or not in agreement. Neither<br > professional call function in a vacuum， yet<br > both tbe audiologist and physician should<br > have a knowledge of the others teclmiques<br > and findings. Tbe audiologist should be<br > able to perform a quick otoscopic exami-<br > nation to evaluate the possibility of ob-<br > struction in the external auditory canal，<br > whereas the physician should be able to<br > use tuning forks to confirm the audiologic<br > evaluation and to arrive at the proper di-<br > agnosis.<br > The otologic evaluation includes a com-<br > plete otologic and related medical history;<br > an otologic and pertinent general examina-<br > tion; and detailed specialized testing as in-<br > dicated， including the audiologic assess-<br > ment.<br > THE OTOLOGIC HISTORY<br > Throughout the evaluation， keep the pa-<br > tient s chief complaint clearly in mind， as<br > this is central to both establishing the di-<br > agnosis as well as achieving patient satis-<br > faction: Why did the patient come to see<br > you? What can you do to relieve this symp-<br > tom?<br > The otologic history must include in-<br > quiring into the five "cardinal signs" of ear<br > padaology: (1) hearing loss， (2) ear pain<br > (otalgia)， 0) ear discharge (otorrhea)， (4)<br > head noise (tinnitus)， and (5) dizziness (ver-<br > tigo). If any of these symptoms are found，<br > detailed characterization helps lead to the<br > diagnosis.<br > The tlollowing outline provides a prelimi-<br > nary "skeleton" on which to organize the<br > history:<br > I. Hearing loss<br > a. ls it unilateral or bilateral? Which<br > side?<br >