Doctors must thoroughly understand the external, middle, and inner ear structures to make sense of symptoms that could be difficult to pin down. It is essential to consider the ear’s relationship to the brain, skull base, and cranial nerves and how these structures interact because certain diseases can affect these areas. In most cases, conductive hearing loss is caused by issues with the middle or outer ear, while sensorineural hearing loss is caused by problems with the inner ear. The external auditory canal is the proper place to insert the otoscope. Make a note of any discomfort you feel while doing so. Check for edema, exudate, wax, foreign items, and the existence or absence of a mastoid cavity (caused by a previous “canal-wall-down” mastoidectomy) in the canal. Check for perforation, sclerosis, and retraction of the tympanic membrane if it is apparent. Noting whether or not a proper light reflex is present is essential. Thoroughly search for cholesteatoma in the attic region, just above the tympanic membrane. The tympanic membrane may show bubbles or fluid levels in instances of middle ear effusion.