ears Flashcards
What is external otitis, commonly known as swimmer’s ear?
Inflammation or infection of the epithelium of the auricle and ear canal.
What are common causes of external otitis?
Swimming, trauma from picking ears, piercing of the auricle, and warm, dark environments promoting microorganism growth.
What microorganisms are responsible for external otitis?
Bacterial: Staphylococcus aureus; Fungal: Candida albicans, Aspergillus; Serious infections: Pseudomonas aeruginosa.
What is malignant external otitis?
A severe infection caused by Pseudomonas aeruginosa in older adults with diabetes, potentially spreading to the parotid gland and temporal bone (osteomyelitis).
What are the symptoms of external otitis?
Ear pain (otalgia), pain with chewing or moving the auricle, serosanguineous or purulent drainage, fever, swelling, and redness.
How is external otitis diagnosed?
Otoscopic examination, culture and sensitivity of drainage, and hearing tests like audiometry, Rinne, and Weber tests.
What challenges occur during otoscopic examination?
Pain when pulling on the pinna or inserting the speculum, and swelling in the canal may obscure the tympanic membrane (TM).
What treatments are used for external otitis?
Topical antibiotics and corticosteroids, systemic antibiotics if surrounding tissue is involved, and moist heat, analgesics, or anesthetic drops for pain control.
What are key interventions for patients with external otitis?
Education on taking antibiotics, using earplugs while swimming, drying ears properly, washing hands before ear drops, using room-temperature drops, and positioning the ear correctly for drops to run in.
How should ear drops be administered?
Ensure they are room temperature, position the ear to allow drops to flow in, and stay in position for at least 2 minutes.
What is chronic otitis media?
A condition resulting from repeated attacks of otitis media, often occurring in adults with a history of recurrent otitis media in childhood.
What are the symptoms of chronic otitis media?
Purulent exudate, inflammation affecting ossicles, auditory tube, and mastoid bone, often painless; hearing loss, nausea, and episodes of dizziness.
How is chronic otitis media diagnosed?
Through otoscopic examination (changes in tympanic membrane color, mobility, or perforation), culture and sensitivity tests, sinus X-rays, MRI, or CT scan of temporal bone.
What medical treatments are used for chronic otitis media?
Otic and systemic antibiotics based on culture and sensitivity; tympanoplasty to reconstruct the tympanic membrane/ossicles, often with mastoidectomy to remove infected mastoid bone.
Why might antibiotic resistance occur in chronic otitis media?
Due to prolonged or recurrent infections leading to resistant bacterial strains.
What is a tympanoplasty?
A surgical procedure to reconstruct the tympanic membrane and/or ossicles, often performed with mastoidectomy.
What postoperative interventions should be taught to a patient after surgery for chronic otitis media?
Change cotton packing and dressing as needed; avoid swimming, air travel, and sun exposure for 6 weeks; do not shampoo for 5 days; sleep on back or unoperated ear for 1 week.
How can patients avoid increasing intracranial or inner ear pressure after surgery?
Keep the mouth open when blowing the nose, coughing, or sneezing.
When should patients contact their healthcare provider after surgery?
If they experience excess drainage or severe dizziness.
When can patients resume strenuous activity and contact sports after surgery?
After 1 month.
What is Ménière disease?
A progressive disorder caused by an accumulation of endolymph in the membranous labyrinth, often affecting one ear.
What are possible causes of Ménière disease?
The exact cause is unknown, but genetic, immune, and environmental factors may play a role.
At what age do symptoms of Ménière disease typically begin?
Between 40 and 60 years of age.
What are the hallmark symptoms of Ménière disease?
Episodic vertigo, tinnitus, ear pressure or fullness, nausea, hearing loss, and balance problems.
What tests are used to diagnose Ménière disease?
Audiometry, vestibular tests (caloric, positional), electronystagmography, glycerol test, and ruling out other causes through H&P.
What findings support a diagnosis of Ménière disease?
Low-frequency sensorineural hearing loss, 2+ spontaneous episodes of vertigo, and abnormal vestibular test results.
What medications are used to manage Ménière disease?
Anticholinergics, antihistamines, antiemetics, benzodiazepines, and diuretics.
What dietary restrictions are recommended for Ménière disease patients?
Reduce sodium, caffeine, nicotine, and alcohol intake.
What surgical options are available for severe cases of Ménière disease?
Endolymphatic sac decompression, endolymphatic shunt, labyrinthectomy, or vestibular nerve section.
What interventions are important during an acute attack of Ménière disease?
Administer medications/IV fluids, provide a quiet, darkened room, avoid sudden movements, implement fall precautions, and help with ambulation as needed.
What environmental changes can help manage symptoms during an acute attack?
Avoid fluorescent or flickering lights, television, and sudden head movements.
What long-term lifestyle modifications can help manage Ménière disease?
Vestibular exercises, rehab, dietary restrictions, and avoiding activities like swimming or being in high places.
What is conductive hearing loss?
Conductive hearing loss occurs when problems in the outer or middle ear impair the transmission of sound waves to the inner ear.
What are the causes of conductive hearing loss?
Impacted earwax, otitis media, tympanic membrane perforation, otosclerosis, allergies, and benign tumors.
What are the manifestations of conductive hearing loss?
The patient may speak softly because their own voice seems loud, and they may hear better in a noisy environment.
What are the interventions for conductive hearing loss?
Identify and treat the underlying cause if possible. Hearing aids may help if the loss is greater than 40-50 dB.
What is sensorineural hearing loss?
Sensorineural hearing loss is caused by damage in the inner ear or the vestibulocochlear nerve.
What are the causes of sensorineural hearing loss?
Congenital and hereditary factors, noise exposure, aging (presbycusis), Meniere disease, trauma, and ototoxicity.
What are the manifestations of sensorineural hearing loss?
Difficulty understanding speech despite hearing sounds, inability to hear high-pitched sounds, muffled speech, dizziness/balance problems, and ear drainage.
What are the interventions for sensorineural hearing loss?
Hearing aids may help but only amplify sound, not clarity; remove earwax; treat infections with antibiotics; tympanoplasty and ossiculoplasty may be considered.
