Is There Still a Place for the Head Mirror?

It’s no surprise that head mirrors are second only to the stethoscope as one of the most recognizable symbols used in artists’ renderings and Hollywood depictions of a physician. Or that, in most cases, head mirrors are incorrectly shown situated squarely in the middle of the “doctor’s” forehead, much like a shiny, silver bull’s eye instead of flipped down over one eye.

What may be surprising is that this iconic, international symbol of physicians has humble mid-eighteenth century origins, dating back to a French accoucheur named Levert who was fascinated with the intricacies of the larynx. And although doctor’s offices have received more than a few technological facelifts since Levert first dabbled with mirrors in 1743, today’s head mirror has withstood the test of time, resembling the one invented one hundred years later, in the mid 1800s.

Despite demonstrating staying power that weathered the industrial revolution and decades of medical advancements, however, some otolaryngologists question if the head mirror can continue to sustain its relevance and trump its younger technological sibling, the fiber optic headlight.

“I think we’ll see less and less of the head mirror,” said Ron Karni, MD, assistant professor in the department of otorhinolaryngology at the University of Texas Medical School at Houston. “If a physician is more comfortable with the mirror, then he or she should continue to use it. However, battery-powered headlights provide excellent illumination, are relatively cheap and can be transported into the hospital or from room to room in the office.”

D.J. Verret, MD, assistant clinical professor at the University of Texas Southwestern Medical School, recalled using head mirrors in exams during his residency years. Most of the residents he trained with still use the head mirror today, he said. “The head mirror is an excellent method for illuminating the nasal and oral cavity and mirror for indirect laryngeal examination,” he added.

“If a physician is more comfortable with the mirror, then he or she should continue to use it.”
—Ron Karni, MD

Split Decision

One of the reasons headlights gained momentum initially is they require less finesse to adjust where the light is focused, virtually eliminating the need for hours of practice learning to position the head mirror correctly.

“Headlights are easier to use because they don’t require the training and experience that head mirrors do,” Dr. Karni said.

Dr. Karni extolled the virtues of the built-in light source and its power to free otolaryngologists from their offices or a patient from the seated position. “It’s convenient that they don’t require a separate light source,” he said.