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Your doctor will use several methods: Otoscopy : Visual examination of the ear canal and eardrum with a lighted instrument Tympanometry : A test that measures how your eardrum responds to pressure changes, helping identify fluid behind it Acoustic reflectometry : Uses sound waves to detect fluid in the middle ear Hearing tests : Audiometry can determine if the fluid is affecting your hearing These painless tests help your ENT specialist assess the severity of the condition and determine the best treatment approach