ear disorder

1. LABYRINTHITIS
It is the inflammation of the inner ear labyrinth. It affects the hearing and balance.
ETIOLOGY
1. Viral or bacterial infection: it usually results from organism that cause acute febrile
diseases, like upper respiratory infections, influenza, pneumonia, measles, mumps,
rubella, polio, hepatitis, bacterial meningitis and chronic otitis media
2. Drug toxicity: taking certain drugs that are dangerous to the inner ear.
3. Over indulgence in alcohol
4. It may occur after an allergy, cholesteatoma
RISK FACTORS
1. Drinking excessive alcohol
2. Fatigue
3. History of allergies
4. Recent viral illness, respiratory infection, or ear infection
5. Smoking
6. Stress
7. Use of certain prescription or non-prescription drugs (especially aspirin)
CLINICAL MANIFESTATIONS
1. The typical presentation is usually with the acute onset of the following
a. Vertigo
b. Nausea
c. Vomiting
2. Spontaneous nystagmus: difficulty in focusing the eyes because of involuntary eye
movements
3. Dizziness
4. Tinnitus
5. Hearing loss in one ear
6. Purulent discharge in case of bacterial infection
DIAGNOSTIC EVALUATION
1. Ear examination mat not reveal any problems
2. A complete and nervous systema and physical examination should be done
3. Tests will be done to rule out underlying pathology such as EEG,
electronystagmography and head CT scan
4. Audiometry is done to assess the level of hearing loss
5. Warming and cooling the inner ear with air or water to test eye reflexes and to rule
out Meniere’s disease
6. CT scan to rule out any brain lesion
7. Electronystagmography and tympanometry may be done
8. Culture and sensitivity, if purulent discharge is present.

2. PATHOPHYSIOLOGY
MANAGEMENT
It usually goes away within a few goes away within a few weeks. Treatment helps to reduce
symptoms, mediations that may reduce symptoms are used for three days. These drugs
include:
1. Antihistamines such as diphenhydramine
2. Compazine may also used to control nausea and vomiting
3. Medicines to relieve dizziness, such as Meclizine or Scopolamine
4. Sedative hypnotics such as valium, benzodiazepines (diazepam, lorazepam) may be
given to relieve symptoms

3. 5. Antiemetics (promethazine, metoclopramide) to manage nausea and vomiting.
Compazine may also be used to control nausea and vomiting
6. Vestibular rehabilitation is often recommended.
SURGICAL MANGEMENT
1. Surgical drainage of infected areas of middle and inner ear
2. Labyrinthectomy
3. Vestibular nerve section.
NURSING MANAGEMENT
1. Provide a safe environment by:
a. Keeping bed rails up
b. Maintaining bed in a low position
c. Keeping bedside free from clutter
2. Allow the patient to perform tasks at his/her own pace
3. Advice patient to move slowly
4. Encourage the patient to seek assistance as necessary
5. If patient is smoker, he/ she should stop it as cigarette has nicotinic and which causes
vasospasm
6. Provide low sodium diet
7. Administer prescribed medicines
8. Oral fluids to prevent dehydration due to vomiting
9. Place the call light on the patient’s bedside
10. Bed rest with head immobilized between pillows to be provided
11. Avoid exercise where body balance cannot be maintained
12. Discuss with patient about the nature of disease and management. It will enhance
cooperation
13. Speak slowly in short sentences as patient may have hearing problem
14. Reassure patient and provide psychological support.
COMPLICATIONS
1. Injury to self or others during attacks of vertigo
2. Permanent hearing loss (rare)