Otic Disorders Lecture Flashcards
What is the physiology of Otic Disorder?
Excess moisture in the EAC Local trauma Skin disorders Viral illnesses Aspiration of nasopharyngeal
What are the self treatable otic disorders?
excessive/impacted cerumen
Water clogged ears
Exclusion criteria for self-treatment of otic disorders?
Signs of infections Pain with ear discharge Bleeding/trauma Ruptured tympanic membrane Ear surgery 6 weeks prior Tympanostomy tubes present Can't follow instructions Less than 12 years old
What is involved with excessive/impacted cerumen?
Mixture of oily secretions from exocrine glands and milky, fatty fluid of apocrine glands
Lubricates ear canal, traps dust and foreign material
What are the risk factors with excessive/impacted cerumen?
Abnormally misshapen/narrow physiology Excessive hair growth in canal Overactive ceruminous gland Obstruction Age
What are the signs/symptoms with excessive/impacted cerumen?
- Pressure or fullness
- Gradual loss of hearing
What are complications with excessive/impacted cerumen?
Impaction: fullness/pressure in ear
Gradual hearing loss
Infection
Rare: mild pain, vertigo
What are the treatment goals of with excessive/impacted cerumen?
Soften for removal safely and effectively
What are treatments for with excessive/impacted cerumen?
Non-pharmacologic treatment: damp washcloth over finger
FDA Approved Pharmacologic treatment: carbamide peroxide
Other treatments: mineral oil, docusate sodium, olive oil, glycerin, dilute H2O2
What is carbamide peroxide?
Only FDA approved oTC product for softening loosening and removing excessive earwax in adults and 12+
Adverse effects of carbamide peroxide?
Nonirritating: may experience pain, rash, irritation, tenderness, redness, discharge, dizziness
Rash: dermatitis
What are predisposing factors, signs/symptoms, goals to water clogged ears?
Shaped of person’s ear canals, excess cerumen and moisture
Wetness or fullness in ear, gradual loss of hearing, tissue maceration
Goals: dry EAC safely and effectively
What is isopropyl alcohol 95% in anhydrous glycerin?
Only FDA approved eardrying aid Use 4-5 drops in ear canal Let it remain for 1-2 minutes Do not use in children less than 12 Don not use for more than 4 days
Drugs involved in water clogged ears?
Acetic acid + isopropyl alcohol
Acetic = batericidal and antifungal
Isopropyl alcohol is drying agent
Always refer if…?
Fever
Severe pain
Discharge
Itching
What are predisposing factors, signs/symptoms, goals to otitis media?
Viral upper respiratory infection
Bacterial infection of middle ear
Signs: sharp steady pain, fever, hearing loss, drainage from ear, dizziness, inner ear pressure
What are predisposing factors to otitis externa?
“Swimmer’s Ear”
Humid air, water activities, trauma to ear
Usually involves pseudomonase aeruginosa
What are the sign and symptoms and prevention strategies for otitis externa?
Acute Pain
Itching and inflammation
Foul smelling watery discharge from EAC
Mechanical barriers
What is a ruptured tympanic membrane?
Short duration of severe pain followed by loss of hearing
Refer immediately
Ruptured tempanic membrane: Pain? Itching? Hearing loss? Discharge?
Brief, severe
None
Abrupt
If associated with OM
Swimmer’s ear: Pain? Itching? Hearing loss? Discharge?
Acute onset
Yes
Occasionally
Occasionally
Otitis Media: Pain? Itching? Hearing loss? Discharge?
Sharp, steady
No
May be decreased
Possible
Foreign object: Pain? Itching? Hearing loss? Discharge?
Dull to severe
Yes
Yes Possible
Trauma: Pain? Itching? Hearing loss? Discharge?
Yes, varies
Rare
Varies
Seldom
