This document provides an outline and information about common ear problems. It begins with learning objectives which are to describe hearing loss, list external, middle, and internal ear problems, and apply nursing knowledge to manage common ear issues. It then discusses hearing tests and the types of hearing loss. The rest of the document covers specific ear disorders like cerumen impaction, foreign bodies, external otitis, tympanic membrane perforation, various forms of otitis media, otosclerosis, and mastoiditis. For each topic it provides definitions, causes, signs/symptoms, and medical and surgical management approaches.
Hearing is one of our primary modes of communication. 360 million people worldwide have disabling hearing loss.
Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise and ageing.
Hearing loss may be mild, moderate, severe or profound.
It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds. it may occur in one or both ear.
CONDUCTIVE HEARING LOSS (CHL)
SENSORINEURAL HEARING LOSS (SHL)
MIXED HEARING LOSS (MHL)
Trauma to the auricle and ear canal
Its Complications
Treatment plan
Ear wax ,its composition, clinical features and management
Foreign body to the ear and its types
Treatment for foreign body in ear
Hematoma of The Auricle
Collection of blood between the auricular cartilage and its perichondrium.
Often result of blunt trauma seen in boxers, wrestlers and rugby players.
Extravasated blood may clot and then organize, resulting in a typical deformity called cauliflower ear (pugilistic or boxer’s ear)
If hematoma gets infected, severe perichondritis may occur.
defness is also known as the loss of hearing of the ear and this is a chronic condition which need proper treatment as if cannot be detected early it can cause serious problem of hearing loss so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too
Hearing is one of our primary modes of communication. 360 million people worldwide have disabling hearing loss.
Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise and ageing.
Hearing loss may be mild, moderate, severe or profound.
It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds. it may occur in one or both ear.
CONDUCTIVE HEARING LOSS (CHL)
SENSORINEURAL HEARING LOSS (SHL)
MIXED HEARING LOSS (MHL)
Trauma to the auricle and ear canal
Its Complications
Treatment plan
Ear wax ,its composition, clinical features and management
Foreign body to the ear and its types
Treatment for foreign body in ear
Hematoma of The Auricle
Collection of blood between the auricular cartilage and its perichondrium.
Often result of blunt trauma seen in boxers, wrestlers and rugby players.
Extravasated blood may clot and then organize, resulting in a typical deformity called cauliflower ear (pugilistic or boxer’s ear)
If hematoma gets infected, severe perichondritis may occur.
defness is also known as the loss of hearing of the ear and this is a chronic condition which need proper treatment as if cannot be detected early it can cause serious problem of hearing loss so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too
meniere disease is the inner ear condition which affect the patient haring and balance this ppt can help the nurses to take care of the patient affected with this disease and can be used as a study material for their examination
Describe nursing assessment of the ear, sinuses ,nose, throat.
Identify nursing responsibilities for patient undergo diagnostic test or procedure for ear, sinuses, nose, throat.
Describe the common therapeutic measures for ear, sinuses ,nose, throat.
Explain the pathophysiology, etiology, clinical manifestation and treatment for ENT disorders.
Assist in developing nursing care plans for patient with ENT disorders.
meniere disease is the inner ear condition which affect the patient haring and balance this ppt can help the nurses to take care of the patient affected with this disease and can be used as a study material for their examination
Describe nursing assessment of the ear, sinuses ,nose, throat.
Identify nursing responsibilities for patient undergo diagnostic test or procedure for ear, sinuses, nose, throat.
Describe the common therapeutic measures for ear, sinuses ,nose, throat.
Explain the pathophysiology, etiology, clinical manifestation and treatment for ENT disorders.
Assist in developing nursing care plans for patient with ENT disorders.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
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the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Learning objectives
• At the end of this session you will be able:
– Describe hearing loss
– List:
• External ear problems
• Middle ear problems
• Internal ear problems
– Apply nursing knowledge in the management of
common ear problems
7/1/2023 2
5. Hearing tests (Acuity, Weber and Rinne tests)
Hearing status Weber Rinne
Normal hearing Sound is heard
equally in both
ears
Air conduction is
audible longer
than bone
conduction
Conductive
hearing loss
Sound is heard
best in affected
ear
(Hearing loss).
Sound is heard
as long or longer
in affected
ear(hearing loss).
Sensorineural
hearing loss
Sound is heard
best in normal
hearing ear.
Air conduction is
audible longer
than bone
conduction
In affected ear.
7. Hearing loss
• Hearing impairment has been reported to occur in 3 of
every 1000 births
• Hearing loss is greater in men than in women.
Conductive hearing loss = results from an external ear or a
middle ear disorder
A sensorineural loss = damage to the cochlea or
vestibulocochlear nerve.
Mixed hearing loss
Conductive loss and sensorineural loss, resulting from dysfunction of
air and bone conduction.
7/1/2023 13
8. Risk Factors for Hearing Loss
Family history of sensorineural impairment
Congenital malformations of the cranial structure (ear)
Low birth weight (1500 g)
Use of ototoxic medications (eg, gentamycin, loop
diuretics)
Recurrent ear infections
Bacterial meningitis
Chronic exposure to loud noises
Perforation of the tympanic membrane
7/1/2023 14
9. Clinical Manifestations
Tinnitus
Increasing inability to hear when in a group
And a need to turn up the volume of the television.
Changes in attitude
The ability to communicate, the awareness of
surroundings
7/1/2023 15
10. Clinical Manifestations….
Be alert the ff points for hearing loss
• Speech deterioration- ears guide the voice, both in
loudness and in pronunciation.
• Fatigue: result of straining to hear
• Indifference: depressed and disinterested in life
• Social withdrawal
• Insecurity- lack of self-confidence and fear of mistakes
• Indecision and procrastination
• Suspiciousness- suspect that others are talking about
him or her
• False pride:
• Loneliness and unhappiness
• Tendency to dominate the conversation
7/1/2023 16
11. Nursing Management
Adopting a communication style to fit the needs and preferences
of each patient.
Cerumen can be removed by irrigation, suction, or
instrumentation.
Gentle irrigation usually helps remove impacted cerumen.
Instilling a few drops of warmed glycerin, mineral oil, or half-
strength hydrogen peroxide into the ear canal for 30 minutes can
soften cerumen before its removal.
7/1/2023 17
14. Cerumen Impaction
• Cerumen normally accumulates in the
external canal in various amounts and colors.
• occasionally causes
– otalgia,
– a sensation of fullness or pain in the ear,
with or without a hearing loss, especially in
the elderly
• Attempts to clear the external auditory canal
with matches, hairpins, and other implements
are dangerous (b/c of trauma to the skin,
infection, and damage to the tympanic
membrane )
7/1/2023 20
15. Management
• Removed :
– Irrigation=Water stream flow behind : the
obstructing cerumen to move it first laterally and
then out of the canal
– For perforated eardrum behind the impaction is
perforated, water can enter the middle ear,
producing acute vertigo and infection.
– Suction
– Instrumentation = unsuccessful, irrigation direct
visual, mechanical removal
• Ceruminolytic agents, such as peroxide in glyceryl
,but may cause an allergic dermatitis reaction.
7/1/2023 21
16. Foreign bodies
• Some objects are inserted
– Intentionally into the ear
– Trying to clean the external canal or
relieve itching
– Children who introduce peas, beans,
pebbles, toys, and beads.
– Insects
7/1/2023 22
17. Management
• Removing a foreign body from the external auditory
canal is quite challenging.
• Three standard methods
– Irrigation= Contraindications in vegetable
bodies and insects
– Suction
– Instrumentation
• Instilling mineral oil, which will kill the insect and
allow it to be removed.
7/1/2023 23
18. Management
• Drug treatment: Patient should be kept on antibiotic if there is
sign of infection on the ear canal or purulent discharge
First line:
Amoxicillin, 500mg P.O. TID for 10 days for adults;
250mg P.O. TID for 10 days for children above 6
years of age; 125mg/5ml OR 250mg/5ml P.O. TID
10 days for children under 6 years of age.
OR
Amoxicillin/ clavulanate, 375mg P.O. TID for 10
days or 625mgP.O. BID 10 days for adults;
156mg/5ml P.O. TID OR 312mg/5ml P.O. TID for
10 days for children.
7/1/2023 24
19. Management
OR
• Cloxacillin, 500mg P.O. QID for 10 days for adults;
50-100mg/kg/day P.O. divided into 4 doses for10
days for children.
Aternatives
• Oxytetracycline hydrochloride + Polymyxin B
Sulphate + Hydrocortizone acetate, 2drops 2-3
times daily
OR
• Chloramphenicol, 2-3 drops 2-4 times daily
7/1/2023 25
20. External otitis
• External otitis, or otitis externa, refers to an
inflammation of the external auditory canal.
• Causes:
– water in the ear canal (swimmer’s ear);
– Trauma to the skin of the ear canal,
– vitamin deficiency and endocrine disorders.
– Bacterial or fungal infections
– Staphylococcus aureus and Pseudomonas species.
– allergic reactions
7/1/2023 26
22. Clinical Manifestations
• Pain,
• Discharge from the external auditory canal,
(yellow or green and foul-smelling)
• Aural tenderness (usually not present in
middle ear infections),
• Fever, cellulitis, and lymphadenopathy.
• Pruritus and hearing loss or a feeling of
fullness.
• On otoscopically, ear canal is erythematous
and edematous.
7/1/2023 28
23. Medical Management
• Principles of therapy :
– Relieving the discomfort,
– Reducing the swelling of the ear canal, and
– Eradicating the infection.
• Analgesic may be used for the first 48 to 92
hours.
• Edematous, a wick should be used
• Antibiotic , antifungal and corticosteroid agents
to soothe the inflamed tissues.
7/1/2023 29
24. Medical Management
• Drug treatment
First line: Oxytetracycline hydrochloride +
polymyxin B sulphate + hydrocortizone acetate,
2 drops 2-3 times daily.
Alternatives
• Cloxacillin, Adults; 500mg P.O. QID for 7 – 10
days.
• Children; 50-100mg/Kg/day P.O. divided into 4
doses for 7 –10 days.
7/1/2023 30
25. Drug treatment
OR
• Amoxicillin, Adults; 250-500mg P.O. TID for 7 -
10 days. Children; 50-100mg/kg P.O. TID for 7
– 10 days
OR
• Trimtethoprim + Sulfamethoxazole,
OR
• Erythromycin, Adults; 250-500mg P.O. QID.
Children; 30-50mg /kg P.O. QID OR 15-
20mg/kg IV every 4-6hrs.
7/1/2023 31
26. Nursing Management
• Instruct not to clean the external auditory
canal with cotton-tipped applicators and to
avoid events that traumatize the external
canal
• Avoid getting the canal wet when swimming
or shampooing the hair.
• A cotton ball can be covered in a water
insoluble gel such as petroleum jelly and
placed in the ear as a barrier to water
contamination.
7/1/2023 32
30. Medical Management
• Most tympanic membrane perforations heal
spontaneously
• Some may take several months to heal.
• Some persist
• In the case of a head injury or temporal bone
fracture, a patient is observed for evidence of
cerebrospinal fluid
7/1/2023 37
31. Surgical Management
• Non healing on their own may require
surgery.
• Tympanoplasty (surgical repair of the
tympanic membrane)
7/1/2023 38
32. Otitis media
A. Acute otitis media
• An acute infection of the middle ear, usually lasting <
6 weeks.
• Cause is usually
– Streptococcus pneumoniae
– Haemophilus influenzae
– Moraxella catarrhalis
• A purulent exudate is usually present in the middle
ear, resulting in a conductive hearing loss.
7/1/2023 39
34. Clinical Manifestations
• Symptoms vary with the severity of the
infection.
• Otalgia
• Drainage from the ear,
• Fever, and hearing loss.
• On otoscopic examination, the external
auditory canal appears normal, tympanic
membrane is erythematous and often
bulging.
7/1/2023 41
35. Medical Management
• Outcome of AOM depends on
– Efficacy of therapy
– Virulence of the bacteria
– Physical status of the patient.
• Early and appropriate broad spectrum
antibiotic therapy, may resolve with no
serious sequelae.
• Rarely does permanent hearing loss .
• Secondary complications involving the
mastoid and other serious intracranial
complications, such as meningitis or brain
abscess
7/1/2023 42
36. Surgical Management
• Myringotomy (ie, tympanotomy).
– Incision in the tympanic membrane = heals
within 24 to 72 hours
– Myringotomy also allows the drainage to
be analyzed (by culture and sensitivity
testing) so that the infecting organism can
be identified and appropriate antibiotic
therapy prescribed.
7/1/2023 43
37. Clinical features of otitis
Feature externa Acute otitis externa Acute otitis media
Otorrhea May or may not be
present
Present if tympanic
membrane perforates;
discharge is profus
Otalgia Persistent, may awaken
patient at night
Relieved if tympanic
membrane ruptures
Aural tenderness Present on palpation of
auricle
Usually absent
Systemic symptoms Absent Fever, upper respiratory
infection, rhinitis
Edema of external
auditory canal
Present Absent
Tympanic membrane May appear normal Erythema, bulging, may
be perforated
Hearing loss Conductive type Conductive type
7/1/2023 44
38. Serous Otitis Media
• Serous otitis media (middle ear effusion)
involves fluid, without evidence of active
infection, in the middle ear.
• In theory, this fluid results from a negative
pressure in the middle caused by eustachian
tube obstruction.
•
• Frequently seen in patients after radiation
therapy or barotrauma and eustachian tube
dysfunction
• A carcinoma (eg, nasopharyngeal cancer)
obstructing the eustachian tube should be
ruled out in adults with persistent unilateral
serous otitis media.
7/1/2023 45
39. Clinical Manifestations
• Complain of hearing loss, fullness in the ear
• Sensation of congestion, or popping and
crackling noises
• Tympanic membrane appears dull on
otoscopy, and air bubbles may be visualized
in the middle ear.
• Usually, the audiogram shows a conductive
hearing loss.
7/1/2023 46
40. Management
• Serous otitis media need not be treated
medically unless infection (ie, AOM) occurs.
• A myringotomy can be performed, and a tube
may be placed to keep the middle ear
ventilated.
• Corticosteroids in small doses may decrease
edema of the eustachian tube in cases of
barotrauma.
• Decongestants have not proved effective.
7/1/2023 47
41. Chronic Otitis Media
• Result of recurrent AOM
• Cause irreversible tissue pathology and
persistent perforation of the tympanic
membrane.
• Damage the tympanic membrane, ossicles,
and involve the mastoid.
• Before the discovery of antibiotics, infections
of the mastoid were life-threatening.
7/1/2023 48
43. Clinical Manifestations
• Symptoms may be minimal, with varying degrees of
hearing loss and a persistent or intermittent, foul-
smelling otorrhea.
• Pain is not usually experienced,
• Otoscopic: perforation, and cholesteatoma( white
mass behind the tympanic membrane).
• Cholesteatoma is an ingrowth of the skin of the
external layer of the eardrum into the middle ear(
chronic retraction pocket of the tympanic membrane)
• Chronic otitis media can cause chronic mastoiditis
and lead to the formation of cholesteatoma.
7/1/2023 50
44. Medical Management
• Local treatment of chronic otitis media
consists of careful suctioning of the ear
under otoscopic guidance.
• Instillation of antibiotic drops or application
of antibiotic powder is used to treat purulent
discharge.
• Systemic antibiotics are prescribed only in
cases of acute infection.
7/1/2023 51
45. Surgical Management
• Including:
– Tympanoplasty - most common , surgical
reconstruction of the tympanic membrane
– Ossiculoplasty- surgical reconstruction
of the middle ear bones to restore hearing
– Mastoidectomy- to remove the
cholesteatoma
7/1/2023 52
46. Otosclerosis
• Involves the stapes and result from the
formation of new, abnormal spongy bone,
especially around the oval window
• The efficient transmission of sound is
prevented because the stapes cannot vibrate
and carry the sound as conducted from the
malleus and incus to the inner ear.
• More common in women and frequently
hereditary, and pregnancy may worsen it.
7/1/2023 53
47. Clinical Manifestations
• May involve one or both ears and manifests
as
– A progressive conductive or mixed hearing loss.
– Patient may or may not complain of tinnitus.
– Otoscopic examination usually reveals a normal
tympanic membrane.
– Bone conduction is better than air conduction
on rinne testing.
7/1/2023 54
48. Medical Management
• There is no known nonsurgical treatment
for otosclerosis.
• However, some physicians believe the use of
sodium fluoride can mature the abnormal
spongy bone growth and prevent the
breakdown of the bone tissue.
• Amplification with a hearing aid also may
help
7/1/2023 55
49. Surgical Management
• Stapedectomy - removing the stapes
superstructure and part of the footplate and
inserting a tissue graft and a suitable
prosthesis
• Stapedotomy- Involves the surgeon drills a
small hole into the footplate to hold a
prosthesis.
7/1/2023 56
51. Ménière’s disease
• Abnormal inner ear fluid balance caused by a
malabsorption in the endolymphatic sac or a blockage
in the endolymphatic duct.
• Endolymphatic hydrops, a dilation in the
endolymphatic space, develops, and either increased
pressure in the system or rupture of the inner ear
membrane occurs, producing symptoms of ménière’s
disease.
7/1/2023 58
52. Ménière’s disease
• Age of onset in the 40s, beginning b/n the ages of 20
and 60 years.
• Appears to be equally common in men and women,
and it occurs bilaterally in about 20% of patients.
• A positive family history of the disease in 50% of the
cases.
7/1/2023 59
53. Clinical Manifestations
• Fluctuating, progressive sensorineural hearing loss;
• Tinnitus or a roaring sound;
• A feeling of pressure or fullness
• Incapacitating vertigo with nausea & vomiting.
• There are two subsets of the disease:
– Cochlear ménière’s disease - fluctuating,
progressive sensorineural hearing loss associated
with tinnitus and aural pressure
– Vestibular ménière’s disease - episodic vertigo
associated with aural pressure
7/1/2023 60
54. Labyrinthitis
• Inflammation of the inner ear,
• Can be:
– bacterial - rare b/c of antibiotic therapy, but it
sometimes occurs as a complication of otitis media
– Viral in origin- is a common diagnosis, but little is
known about this disorder, which affects hearing
and balance.
• The most common viral causes are mumps,
rubella, rubeola, and influenza.
• Viral illnesses of the upper respiratory tract
and herpetiform disorders of the facial and
acoustic nerves
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55. Clinical Manifestations
• Sudden onset of incapacitating vertigo,
usually with nausea and vomiting,
• Various degrees of hearing loss, and possibly
tinnitus.
• The first episode is usually the worst;
subsequent attacks, which usually occur over
a period of several weeks to months, are less
severe.
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56. Management
• Bacterial labyrinthitis - IV antibiotic, fluid
replacement, and administration of an
antihistamine and antiemetic medications.
• Viral labyrinthitis is based on the patient’s
symptoms.
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Editor's Notes
Outer ear: collects sounds and funnels them through the auditory system.
: has three parts
Pinna (or auricle)
External auditory canal (or external auditory meatus)
Tympanic membrane (or eardrum)
2. Middle ear
Transmits sound from the outer ear to the inner ear.
Consists of an oval, air-filled space .
Eustachian tube :connects the middle ear to the nasopharynx.
Three tiny bones (the ossicles):
Hammer (malleus)
Anvil (incus) and
Stirrup
3. Inner ear
Innermost part of the ear (about the size of a pea) and
complex in shape.
Mainly responsible for sound detection and balance.
Three main components:
1. Vestibule
A round open space which accesses various passageways.
The central structure within the inner ear.
2. Semicircular canals - fluid filled tubes
- a key part of the vestibular system and allow for maintenance of balance when the head or body rotates.
3. Cochlea - dedicated to hearing.
Cholesteatomas are common benign tumors of the inner ear
They usually do not cause pain; however, if treatment or surgery is delayed, they may destroy structures of the temporal bone.
These fast-growing tumors may cause severe sequelae such as hearing loss