News & Reviews

Natus Otometrics Otoscan: clinical review

The Natus Otometrics Otoscan is the latest disruptive innovation by one of the world’s leading audiology equipment manufacturers. It is the first big step in transforming the process for ear moulding on an industry wide scale which will have a significant impact on the care we offer our clients.
Natus Otometrics Otoscan

What is the Otometrics Otoscan?

The Otometrics Otoscan uses 3D laser mapping techniques to construct an exact digital image of our ear. The purpose is to replace the need for ear mould impressions which has historically been achieved using a silicone material.

The use of lasers for 3D imaging has been used by other industries for many years but it is only now they have been able to successfully shrink this technology so that it is able to replicate the intricacies of our ears.

How does Otoscan work?

The Otoscan sends out pulses of laser light. It measures the reflections of this light to establish the distance travelled. It is a similar technique to sonar which is what bats use to ‘see’ their surroundings.

Using clever software, the Otoscan compiles the data to replicate the shape of the ear. It takes hundreds of measurements to construct the image. The more complete the scan, the more accurate the representation will be.

The software is smart enough to communicate when enough data is collected. It represents the image using the following key:

  • Black/Transparent – No data collected
  • Yellow border – some data collected but more required for accurate scan
  • Blue – Sufficient data, move to the next area

Once one part of the scan is blue you move it to another area until the point where all the ear has been scanned. The whole process takes a beginner around 4-5 minutes and a proficient user 2-3 minutes which at present is a little bit quicker than performing ear moulds.

To make the scanning more efficient the Otoscan has 3 modes of operation. I don’t believe they have an official name, but I have outlined them below:

  • Ear canal – this is the first stage. When inside the ear canal the Otoscan uses a ring laser. This focuses more on sending laser light to the side rather than to the front to map the canal walls faster.
  • Flat Surfaces – A line laser is used to map the outer ear / pinna. It is a broader front facing signal that captures the shape of the entire pinna, but this can’t depict all of the intricacies of our outer ear.
  • Curved Surfaces – the finishing mode uses the ring laser again to gather the finer details of the outer ear which is missed by the broad measurement in stage 2. This is critical for accurately representing the concha, antihelix and triangular fossa.

After completing all 3 stages your scan should be complete. The image is saved and you can proceed to upload the scan to Otocloud for safe storage.


Otocloud is a remote server where all your 3D scans are stored. It is an essential add-on to the system and at present it is the only way to transmit your scans to the manufacturers. Otocloud is free to use for owners of the Otoscan.

The manufacturers get at least their first 12 months subscription to Otocloud for free. After this period, they must pay to stay listed so they can receive any scans you may have. If they aren’t on the list, you are unable to send a scan through.


I put the question to Otometrics about why we are forced to use Otocloud. Their representative said that GDPR is the reason that Otocloud is essential. I agree that Otocloud takes away a lot of risk for you as the data controller. It means that your client’s data is transmitted to the manufacturers in a safe and GDPR compliant manner without any effort. My argument is that because we are the data controller, we should have some choice over how our client’s data is being processed. Being forced in to using their platform means that we have no choice but to agree to their terms and conditions.

At some point, other scanners will reach the market with less restraints over how the scans are stored and transmitted. Up until that point Otometrics are in a strong position to maximise their maintain control and optimise profits for their unique device; and rightly so.

Is Otometrics Otoscan worth the money?

This is the big question. On the surface, the Otometrics Otoscan appears expensive. This was my first thought when I heard the price. It’s essential purpose is to make a mould of your ear. So we need to look at whether this is a feasible investment for your business.

The theatre of Otoscan

Otoscan isn’t just taking an ear mould. It’s a demonstration of your clinics interest in innovative technology.

If you get the Otoscan you should use it at every opportunity. Every client that attends for a hearing evaluation should have their ear scanned. It means that you have their ears on record and they get to learn about the anatomy of their ear.

I’m yet to meet someone that hasn’t been impressed with the technology. If they need to take time to think about whether they wish to proceed with hearing aids it means they can put the order in over the phone rather than coming in for another appointment. It also means replica or lost moulds/hearing aids can be processed without the need for repeat ear mould impressions.

Otoscan is a real differentiator for your clinic and cements yourself as a premium provider of hearing care.

Retention/Occlusion issues

Our clients that had existing retention or occlusion issues with their hearing aids were remade with Otoscan to achieve a deeper, more secure fit. This is because you have more control over the depth of the impression with Otoscan. I’ve had some incredible results that have prevented the client from credit returning. In this sense, the scanner has quickly paid for itself.

Depth Gauge

One thing that I initially misunderstood about the Otoscanner is that it calculated the length of the ear canal. I assumed that when it went green it was because the machine had detected on this individual that we had reached an appropriate depth. This is not the case. It uses average data to tell you how deep in the ear you are. Some ears you will need to stop before the green and others, if you feel comfortable, can go deeper. Just be careful not to have an over reliance on this gauge and to instead use the camera to analyse the depth.

Weaknesses of the Otometrics Otoscan


One of the biggest weaknesses of Otoscan is the limiting factors of Otoscloud. Only being able to send the scans to companies that have signed up at present is restricting how often we can use the scanner. We also had some significant teething issues with the associated companies using the Otocloud packages. I won’t be naming and shaming but on more than one occasion order forms were missed, or not chased up

More recently there was a bug in the software which meant the order forms were not attached on to the packages being sent. I understand Otometrics are aware of this and are trying to rectify.

Otoscan also struggles with flat curvy ear canals. You are meant to try and take the scan without touching the canal walls but sometimes this is impossible with certain ears. As such, you are more likely to end up with artefacts or innacurate scans. However, it didn’t take me long to recognise which ears would struggle with scanning and would go straight in with traditional impressions instead.


From a two-dimensional perspective the Natus Otometrics Otoscan is a very expensive way to take ear mould impressions. If you think even just a little bigger, you will see it adds exceptional value to your diagnostic test battery and to the processes within your clinic. It adds 10 minutes to your appointment allowing you time to educate your client on the anatomy of their ear.

I look forward to seeing this technology develop. It has so much potential and may even allow ear mould impressions to be a thing of the past but I’m sure this will be a decade or two away even if this is the case.

Your clients will appreciate you sharing your expert knowledge on your specialist subject. The Otoscan acts as an educational tool to build confidence and rapport with your client and will inevitably lead to more conversions from hearing evaluations.

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