Ear Disorders Flashcards
External Otitis
Inflammation or infection of the epithelium of the auricle and ear canal
causes of external otitis
· Swimmers ear: due to chemical and contaminated water
· Using a sharp object in ear
· Bacteria: pseudomonas aeruginosa
· Fungi: Candida Albicans and Aspergillus
clinical manifestation of external otitis
· Ear pain (otalgia) is the first signs
· Discomfort may be during chewing, moving the auricle, pressing on the tragus
· May have serosanguinous or purulent drainage
Fever
diagnosis of external otitis
Diagnosed by otoscopic examination of the ear canal
Culture and sensitivity may be done
management of external otitis
· Moist heat
· Mild analgesics
· Topical anesthetic drops
· Antibiotics and corticosteroids
· Improvement may be seen in 48 hours, but antibiotic needs to be completed
When applying ear drops
· Wash hands before applying
· Drops should be room temperature
· Cold drops can cause vertigo
· Tip of dropper should not touch the ear during application
· Position ear so that the drops can run into the canal
Patient should stay in this position for 2 minutes to allow the drops to spread
Prevention of External Otitis
· Do not put anything in your ear canal unless requested by your HCP
· Report itching if it becomes a problem
· Earwax is normal (it lubricates and protects the canal, but report chronic excess cerumen if it impairs your hearing)
· Keep ears as dry as possible
Acute otitis media
: infection of the tympanum, ossicles and space of the middle ear
causes of Acute otitis media
· Swelling of the auditory tube from colds or allergies can trap bacteria
· Pressure from the inflammation pushes on the TM, causing it to become red, bulging, and painful.
· Infection can be due to viruses or bacteria.
Otitis media with effusion
inflammation of the middle ear with a collection of fluid in the middle ear space
Clinical Manifestations of Chronic Otitis Media
· Purulent exudate and inflammation that can involve the ossicles, auditory tube and mastoid bone
· Painless, hearing loss, nausea and episodes of dizziness
· Hearing loss is a complication from inflammatory destruction of the ossicles, a TM perforation, or accumulation of fluid in the middle ear space
treatment for otitis media
· IV or oral antibiotics
· Tympanoplasty (myringoplasty) involves reconstruction of the TM and/or the ossicles
post op for otitis media
· Impaired hearing is expected
· A cotton ball dressing is used for the incision
· Instruct the patient to change the cotton packing as needed.
After Ear Surgery
· Sleep on back or unoperated ear for 1 week
· Avoid air travel and sun exposure for 6 weeks
· If you need to cough, keep your mouth open
· Do not shampoo hair for 5 days, wear shower cap when bathing
· Blow nose gently, without blocking either nostril
· No swimming, keep ear dry for 6 weeks
· You may resume strenuous activity and contact sports in 1 month
· Change ear dressing as prescribed
Report excess drainage or severe dizziness to HCP
Meniere’s disease
Abnormal condition within the labyrinth of the inner ear that can lead to a progressive loss of hearing. The symptoms are dizziness or vertigo, hearing loss, and tinnitus (ringing in the ears).
Attacks of menieres disease may be preceded by
a sense of fullness in the ear, increasing tinnitus, and muffled hearing.
Clinical Manifestations of menieres disease
· Episodic vertigo
· Tinnitus
· Fluctuating sensorineural hearing loss
· Aural fullness
· “Drop attacks”
Patient experiences significant disability because of sudden, severe attacks of vertigo with nausea, vomiting, sweating, and pallor. Symptoms usually begin between 30 and 60 years of age
diagnostic test for menieres disease
· Hearing (Audiometric) Tests
· Vestibular Tests for balance
Inner ear assessment: electronystagmography, glycerol test
acute interventions for menieres disease
· Bed rest
· Quiet dark room
· Avoid sudden head movements and position changes
· Avoid fluorescent lights & flashing lights
· Sedation
· Ambulate with assistance only, not independent
· Call light within reach
· Side rails up
· Fall precautions
· Monitor Input & Output
· Antiemetics - Prochlorperazine
· Antivertigo - Meclizine
Verbal & tactile reassurance and support
antiemetic for meiners disease
Prochlorperazine
antivertigo for meiners disease
Meclizine
