Ear Flashcards
What is ear wax and how is it formed?
Ear is produced by the glands in the skin lining the ear canal. Ear wax mainly consists of desquamated epithelium, foreign matter, shed hairs and fatty matter derived from sebacious, ceruminous glands.
Usually it is self cleaning but can harden and dry out due to:
- old age: decerease in cerumen producing glands
- disrupting natural physiological processes (using cotton tip to clean ear).
What are the symptoms of impacted ear wax?
- blocked ear
- ringing in ear
- mild ear ache
- gradual hearing loss
What are the treatments for ear wax?
- over 30% is self limited in 5 days
- cerumenolytics: oil-based preparations that help to soften and disperse wax by emulsification. It’s low surface tension and miscibility allows it to rapidly penetrate the dry matrix of ceruminous mass, reducing it into a semi solid debris that can be ejected by natural physiological processes or syringed out by HCP in severe cases.
e.g. docusate (Waxsol) , carbimide hydroxide (Ear Clear), Sodium Chloride spray (Audiclear) and chloroscresol (cerumol ear drops) - 5 drops, 2-3 times/ day for 5 days.
What are some practice points for ear wax?
- avoid using ear candles and cotton tips
- use wool or vaseline to keep drops in
What are the precautions for the treatment of ear wax?
- okay B/F and preg
- > 2 y.o.
- cant use on inflammed or brokenskin
When should we refer for ear wax?
- dizziness or tinnitus (inner ear)
- fever
- pain from middle ear
- foreign body
How should ear drops be administered?
- warm bottle with hands (too cold or hot can lead to dizziness when placed in ear canal)
- lie down with affected ear face up
- gently pull the ear back to help straighten the ear canal
- hold the dropper over the ear and squeeze out the recommended drops
- massage the tragus over the ear canal. This will help force the ear drops down the ear canal.
- wait for minute
- Sit up and allow the excess drops to drain out.
What are the causes of swimmer’s ears?
- dermatitis
- trauma
- prolonged exposure of the ear to moisture
What are the symptoms of swimmer’s ear?
- itchy
- irritation
- pain while moving (esp with chewing)
- disharge (usually clear)
- mild hearing loss
- feeling pressure of fullness in ear
What are the treatments for swimmers ear?
- corticosteroids
- antifungals, antibacterials
- oral antibiotics
e.g. ear clear swimmers ear: isoproyl alcohol helps to dry the moisture and acetic acid helps to restore pH and makes skin less prone to infection. 4-6 drops in each ear after swimmer or bathing.
What are the precautions for otitis externa?
- okay for preg/ bf
- do not use on broken or inflammed skin
- cant use on perforated eardrum or tympanostomy tube
What are some practice points for otitis externa?
- use wool smothered in vaseline while showering
- use ear plugs or cap while swimming
- keep ears clean and dry while using treatment and 2 weeks after treatment
what is otitis media?
inflammation of the middle ear with a build up of fluid due to a bacterial or viral infection. It often starts with a common cold.
What are the symptoms of otitis media?
- fluid build-up
- pain and fever
- irritability
What are the treatments for otitis media?
- generally paracetamol to manage the pain
- but also antibiotics depending on the fever, age and duration of problem, usually used for special group. however can speed up treatment and reduce complications if used early.
e.g. amoxicillin or cefuroxime.
