1. Labyrinthitis is an inner ear inflammation that causes severe vertigo, nausea, hearing loss and imbalance.
2. It is usually caused by viral or bacterial infections, such as those causing colds or ear infections.
3. Treatment focuses on relieving symptoms through bed rest, medications and sometimes surgery. Patients require care to prevent falls and dehydration during recovery.
Hearing loss is one of the most frequent sensory deficient in human population. It affects more than 360 million people.
Consequences of hearing impairment include reduced ability to communicate, economic and educational disadvantage, social isolation and stigmatization.
we will talk also about the common types & causes of hearing loss and the possible applicable methods to treat these conditions.
This document discusses disorders of the auditory nervous system, including acoustic neuromas and auditory neuropathy spectrum disorder. It begins by categorizing auditory nervous system disorders as affecting the auditory nerve, cochlear nuclei, or higher pathways. Acoustic neuromas are benign tumors of the auditory nerve that can cause hearing loss and tinnitus. Auditory neuropathy spectrum disorder involves abnormal nerve transmission from the cochlea to brainstem. The document also covers evaluation, diagnosis and management of these conditions.
The document discusses the three main types of hearing loss: sensorineural hearing loss, conductive hearing loss, and mixed hearing loss. Sensorineural hearing loss is damage to the inner ear or auditory nerve and is the most common, affecting around 90% of people with hearing loss. Conductive hearing loss occurs when sound is not adequately transmitted from the outer to inner ear, often due to blockages. Mixed hearing loss is a combination of both sensorineural and conductive losses. Seeing an audiologist can determine the type of hearing loss and best treatment options.
Auditory neuropathy spectrum disorder (ANSD) is characterized by normal outer hair cell function but abnormal or absent auditory brainstem response, despite mild to profound hearing loss. A 27-year-old female presented with right-sided hearing loss, vertigo, and tinnitus for several years. Testing found normal outer hair cell function but abnormal auditory brainstem responses, consistent with progressive ANSD. Treatment options for ANSD are limited but may include hearing aids, cochlear implants, or speech therapy depending on the severity and progression of the hearing loss.
This document discusses the management of deaf children. It notes that early identification of hearing loss through screening tests like OAEs and ABR is important for development of speech, as the period from birth to 5 years is critical. The causes of deafness can be genetic, such as mutations in the GJB2 and GJB6 genes, or non-genetic like infections during pregnancy or birth injuries. Evaluation of deaf children involves screening tests followed by behavioral and objective tests like ABR to determine the type and degree of hearing loss and its cause. Early intervention is important to facilitate speech and language development in deaf children.
Ms. Elizabeth presented on age-related hearing loss (presbycusis). It is a common condition linked to aging where hearing is slowly lost in both ears, with about 30 out of 100 adults over 65 having some hearing loss. Causes include long-term noise exposure, aging, genetics, certain health conditions, medications, race, income level, infections, and smoking. Symptoms are difficulty hearing conversations, high pitches, or sounds that seem too loud. Diagnosis involves tests of the ear canal, eardrum, hearing levels, and middle ear function. Treatments include hearing aids, assistive devices, speech reading, cochlear implants, and middle ear implants. Nursing considerations are involving family, speaking slowly
This document provides an overview of assessment and management of deafness in children and adults. It discusses types of hearing impairment, common causes including genetic factors and infections, methods of evaluation such as audiometry, and interventions like hearing aids, cochlear implants, education supports, and protective measures to prevent deafness.
This document summarizes various causes and types of sensori-neural hearing loss (SNHL). It notes that SNHL affects 278 million people worldwide according to the WHO, and is one of the top 20 global burdens of disease. Causes include genetic syndromic and non-syndromic conditions present at birth, as well as acquired causes like presbyacusis, noise-induced hearing loss, ototoxicity from certain drugs, trauma, and idiopathic sudden SNHL. Ototoxic drugs like aminoglycoside antibiotics and chemotherapy agents can cause permanent SNHL. Prevention, early detection, and treatment options vary depending on the underlying cause.
Hearing loss is one of the most frequent sensory deficient in human population. It affects more than 360 million people.
Consequences of hearing impairment include reduced ability to communicate, economic and educational disadvantage, social isolation and stigmatization.
we will talk also about the common types & causes of hearing loss and the possible applicable methods to treat these conditions.
This document discusses disorders of the auditory nervous system, including acoustic neuromas and auditory neuropathy spectrum disorder. It begins by categorizing auditory nervous system disorders as affecting the auditory nerve, cochlear nuclei, or higher pathways. Acoustic neuromas are benign tumors of the auditory nerve that can cause hearing loss and tinnitus. Auditory neuropathy spectrum disorder involves abnormal nerve transmission from the cochlea to brainstem. The document also covers evaluation, diagnosis and management of these conditions.
The document discusses the three main types of hearing loss: sensorineural hearing loss, conductive hearing loss, and mixed hearing loss. Sensorineural hearing loss is damage to the inner ear or auditory nerve and is the most common, affecting around 90% of people with hearing loss. Conductive hearing loss occurs when sound is not adequately transmitted from the outer to inner ear, often due to blockages. Mixed hearing loss is a combination of both sensorineural and conductive losses. Seeing an audiologist can determine the type of hearing loss and best treatment options.
Auditory neuropathy spectrum disorder (ANSD) is characterized by normal outer hair cell function but abnormal or absent auditory brainstem response, despite mild to profound hearing loss. A 27-year-old female presented with right-sided hearing loss, vertigo, and tinnitus for several years. Testing found normal outer hair cell function but abnormal auditory brainstem responses, consistent with progressive ANSD. Treatment options for ANSD are limited but may include hearing aids, cochlear implants, or speech therapy depending on the severity and progression of the hearing loss.
This document discusses the management of deaf children. It notes that early identification of hearing loss through screening tests like OAEs and ABR is important for development of speech, as the period from birth to 5 years is critical. The causes of deafness can be genetic, such as mutations in the GJB2 and GJB6 genes, or non-genetic like infections during pregnancy or birth injuries. Evaluation of deaf children involves screening tests followed by behavioral and objective tests like ABR to determine the type and degree of hearing loss and its cause. Early intervention is important to facilitate speech and language development in deaf children.
Ms. Elizabeth presented on age-related hearing loss (presbycusis). It is a common condition linked to aging where hearing is slowly lost in both ears, with about 30 out of 100 adults over 65 having some hearing loss. Causes include long-term noise exposure, aging, genetics, certain health conditions, medications, race, income level, infections, and smoking. Symptoms are difficulty hearing conversations, high pitches, or sounds that seem too loud. Diagnosis involves tests of the ear canal, eardrum, hearing levels, and middle ear function. Treatments include hearing aids, assistive devices, speech reading, cochlear implants, and middle ear implants. Nursing considerations are involving family, speaking slowly
This document provides an overview of assessment and management of deafness in children and adults. It discusses types of hearing impairment, common causes including genetic factors and infections, methods of evaluation such as audiometry, and interventions like hearing aids, cochlear implants, education supports, and protective measures to prevent deafness.
This document summarizes various causes and types of sensori-neural hearing loss (SNHL). It notes that SNHL affects 278 million people worldwide according to the WHO, and is one of the top 20 global burdens of disease. Causes include genetic syndromic and non-syndromic conditions present at birth, as well as acquired causes like presbyacusis, noise-induced hearing loss, ototoxicity from certain drugs, trauma, and idiopathic sudden SNHL. Ototoxic drugs like aminoglycoside antibiotics and chemotherapy agents can cause permanent SNHL. Prevention, early detection, and treatment options vary depending on the underlying cause.
The document discusses the anatomy and physiology of the ear. It describes the external, middle, and inner ear structures. The external ear collects sound waves. The middle ear contains the tympanic membrane and ossicles that transmit sound to the inner ear. The inner ear contains the cochlea for hearing and vestibular system for balance. It also discusses different types of hearing loss including conductive, sensorineural, and mixed. Common causes and treatments are provided for different types of hearing impairment such as otosclerosis, Meniere's disease, and tinnitus. Diagnostic tests including audiometry and tuning fork tests are also summarized.
This document discusses disorders of the outer, middle, and inner ear that can cause conductive, sensorineural, and mixed hearing loss. It describes the pathologies that can occur in the outer, middle, and inner ear including wax buildup, infections, fractures, and more. Common tests used to diagnose the type of hearing loss like audiograms and tympanograms are explained. Finally, it outlines treatment options for different types of hearing loss including medical, surgical, hearing aids, and cochlear implants.
Austin Otolaryngology is an open access, peer review journal publishing original research & review articles in all the fields of Otolaryngology. Otolaryngology deals with the study of ear, nose and throat. Austin Otolaryngology provides a new platform for students to publish their research work & update the latest research information in Otolaryngology.
Austin Otolaryngology is a comprehensive Open Access peer reviewed scientific Journal that covers multidisciplinary fields. We provide limitless access towards accessing our literature hub with colossal range of articles. The journal aims to publish high quality varied article types such as Research, Review, Short Communications, Case Reports, Perspectives (Editorials), Clinical Images.
Austin Otolaryngology supports the scientific modernization and enrichment in Otolaryngology research community by magnifying access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed member journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary science.
Ototoxicity refers to damage to the inner ear caused by certain drugs or chemicals. Common ototoxic drugs include aminoglycoside antibiotics, loop diuretics, cytotoxic agents, antiprotozoals, antiepileptics, and environmental chemicals. Symptoms of ototoxicity include hearing loss, tinnitus, and balance disorders and can be temporary or permanent depending on the offending agent. Diagnosis involves assessing a patient's exposure history and test results. While there are no treatments to reverse damage, management focuses on rehabilitation and avoiding further ototoxic exposure.
Patients can experience different types of hearing loss, including conductive, sensorineural, and mixed. A history and physical exam including tuning fork tests help distinguish the type of loss. Common etiologies include otosclerosis, presbycusis, noise exposure, and Meniere's disease. Formal audiologic testing is needed to diagnose the condition and guide management, which may include hearing aids, surgery, or lifestyle modifications.
Children who are profoundly deaf fail to develop speech without intervention. Early identification and management of hearing loss before 6 months of age leads to better language development. Causes of deafness can be prenatal, perinatal, or postnatal. Evaluation involves ruling out causes and assessing hearing through objective tests like ABR. Management includes hearing aids, cochlear implants, speech therapy, and special education. Early intervention is important for optimal outcomes.
Auditory neuropathy is a hearing disorder where sound enters the inner ear normally but transmission from the inner ear to the brain is impaired. It can be caused by genetic mutations, infections, or other conditions affecting the auditory nerve. On tests, people with auditory neuropathy have normal otoacoustic emissions but abnormal or absent auditory brainstem responses and acoustic reflexes. Treatment involves hearing aids, cochlear implants, or other assistive devices to provide auditory input and support language development.
This document discusses hearing loss, including definitions, types, causes, examination, diagnosis, and management. It defines different levels of hearing loss based on decibel thresholds. The main types are conductive, sensorineural, and mixed hearing loss. Sensorineural hearing loss is usually permanent and caused by inner ear or nerve damage. Causes include genetic syndromes, infections, trauma, tumors, ototoxic drugs, aging, and noise exposure. Evaluation involves history, physical exam including Weber and Rinne tests, and audiometry. Imaging and labs may be needed depending on history. Management depends on type, but may include hearing aids, cochlear implants, rehabilitation through lip reading and sign language. Rehabilitation of children focuses
rehabilitation of a deaf child (PGIMER CHANDIGARH)abhijeet89singh
This document discusses rehabilitation of deaf children. It defines types of hearing loss and outlines screening protocols for identifying childhood hearing impairment. Investigations for determining the cause of hearing loss are described, including recommended levels of testing. Guidelines are provided for managing and intervening with children who have mild to profound hearing loss, including approaches like hearing aids, remote microphone technology, and cochlear implantation. The importance of ongoing monitoring and family support is emphasized to facilitate a child's development.
Introduction
Epidemiology
Pathophysiology
Sign and symptoms
Complication and investigations
Evaluation
Diagnosis
Prevention and management
Treatment
PrognosisSudden
sensorineural hearing loss
This document discusses evaluation and management of deaf children. It begins by defining different types and degrees of childhood hearing loss. Early diagnosis is important as it allows for early intervention, which research shows improves outcomes for language development and education. Universal newborn hearing screening within the first 3 months of life is now standard practice. Diagnostic tests include otoacoustic emissions testing and auditory brainstem response testing. Causes of childhood hearing loss can be genetic syndromic or non-syndromic causes. Proper evaluation involves history, physical exam, and potential genetic or imaging studies to determine the etiology.
The document discusses various causes and types of deafness in children. It describes inner ear abnormalities like Sheibes dysplasia which affects the cochlea and vestibule. It also discusses different types of hearing loss such as conductive, sensory neuronal, and syndromic hearing loss which occurs with other medical problems. The severity of hearing loss is classified from mild to profound based on loudness thresholds. Potential causes include genetic factors, infections during pregnancy, complications at birth, trauma, and certain drugs. Tests used to evaluate hearing include electrocochleography, acoustic reflex testing, tympanometry and audiometry. Management options involve hearing aids, cochlear implants, and developing speech and language skills.
1) Hearing loss in children can impact language development, academic performance, and social skills.
2) The document estimates that 1 to 3 per 1000 infants and 6 per 1000 children will have permanent sensorineural hearing loss.
3) Early identification of hearing loss before 6 months of age and prompt intervention is important to support auditory brain development and maximize outcomes for children.
This document discusses hearing impairment and cochlear implants. It provides background on a 3-year-old male patient who was born with profound sensorineural hearing loss and was approved for cochlear implantation. The document covers topics like types of hearing loss, impact of hearing loss, who is a candidate for cochlear implants, how implants work, the surgery, and factors that influence success. It emphasizes that cochlear implants are effective for severe-to-profound deafness and require a multidisciplinary team approach including programming, therapy, and parental commitment post-surgery.
Hearing loss ranges in severity from mild to profound and affects 360 million people worldwide. There are three main types of hearing loss: conductive, sensorineural, and mixed. Conductive hearing loss is when sound cannot be conducted through the outer ear to the eardrum. Sensorineural hearing loss is damage to the inner ear or auditory nerve pathway. Mixed hearing loss is a combination of conductive and sensorineural. Signs of hearing loss in children include frequent ear infections, delayed language development, and difficulty locating or identifying sounds. Treatment options depend on the severity and include hearing aids, cochlear implants, and osseointegrated devices.
There are several hearing disorders and conditions that can affect hearing and balance, including auditory neuropathy, central auditory processing disorder, different types of hearing loss, middle ear infections, Meniere's disease, otosclerosis, presbycusis, tinnitus, and tumors of the 8th cranial nerve. These disorders can cause issues with sound transmission and processing, as well as temporary or permanent hearing loss. Treatment options may include hearing aids, cochlear implants, antibiotics, surgery, therapy, and assistive listening devices depending on the specific disorder. Anyone experiencing symptoms of hearing or balance problems should seek help from an audiologist.
This document summarizes various disorders that can cause conductive, sensorineural, and mixed hearing losses. It describes pathologies of the outer, middle, and inner ear that result in these types of hearing loss. Treatment options are discussed for each type and include medical, surgical, and amplification approaches. Disorders covered include otitis externa, tympanic membrane perforations, otosclerosis, Meniere's disease, noise-induced hearing loss, and sudden sensorineural hearing loss.
This document discusses hearing screening in newborns. It begins by defining different types and levels of hearing loss. It then discusses the importance of early identification of hearing loss in newborns through universal screening. Screening can be done using otoacoustic emissions testing or auditory brainstem response testing. Otoacoustic emissions testing evaluates the function of the outer hair cells in the cochlea by measuring sounds produced in response to sound stimuli. Early identification of hearing loss allows for early intervention, which research shows leads to better language development and academic outcomes for children.
This document defines ototoxicity as ear poisoning caused by exposure to drugs or chemicals that damage the inner ear and vestibulocochlear nerve. It lists various drugs and chemicals that can cause ototoxicity, including quinine, salicylates, aminoglycosides, loop diuretics, antiepileptics, and betablockers. Signs of ototoxicity include tinnitus, imbalance, vertigo, and hearing loss. Diagnosis involves a health history, physical exam, electrocochleography, and electronystagmography. Management focuses on limiting ototoxic drugs, periodic exams, hearing aids, vestibular exercises, and treating underlying causes.
The document provides information about deafness/hearing loss, including:
1) It defines deafness and hearing loss, and discusses the anatomy and physiology of the ear.
2) It explains the different types of hearing loss (conductive, sensorineural, mixed, etc), as well as the causes, symptoms, and tests used to diagnose hearing loss.
3) It describes some common treatments for hearing loss, including hearing aids, cochlear implants, earwax removal, and assistive devices. It also discusses the nurse's role in caring for patients with hearing loss.
Learning Outcomes:
Students should be able to:
1) Define deafness2) State the etiology of hearing loss
3) Explain the pathophysiology of hearing loss
4) State the clinical manifestation of hearing loss
5) Explain the types of hearing loss
6) Discuss the investigations of hearing loss
7) Describe the treatment of hearing loss patient
8) Carried out nursing care plan for the patient
The document discusses the anatomy and physiology of the ear. It describes the external, middle, and inner ear structures. The external ear collects sound waves. The middle ear contains the tympanic membrane and ossicles that transmit sound to the inner ear. The inner ear contains the cochlea for hearing and vestibular system for balance. It also discusses different types of hearing loss including conductive, sensorineural, and mixed. Common causes and treatments are provided for different types of hearing impairment such as otosclerosis, Meniere's disease, and tinnitus. Diagnostic tests including audiometry and tuning fork tests are also summarized.
This document discusses disorders of the outer, middle, and inner ear that can cause conductive, sensorineural, and mixed hearing loss. It describes the pathologies that can occur in the outer, middle, and inner ear including wax buildup, infections, fractures, and more. Common tests used to diagnose the type of hearing loss like audiograms and tympanograms are explained. Finally, it outlines treatment options for different types of hearing loss including medical, surgical, hearing aids, and cochlear implants.
Austin Otolaryngology is an open access, peer review journal publishing original research & review articles in all the fields of Otolaryngology. Otolaryngology deals with the study of ear, nose and throat. Austin Otolaryngology provides a new platform for students to publish their research work & update the latest research information in Otolaryngology.
Austin Otolaryngology is a comprehensive Open Access peer reviewed scientific Journal that covers multidisciplinary fields. We provide limitless access towards accessing our literature hub with colossal range of articles. The journal aims to publish high quality varied article types such as Research, Review, Short Communications, Case Reports, Perspectives (Editorials), Clinical Images.
Austin Otolaryngology supports the scientific modernization and enrichment in Otolaryngology research community by magnifying access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed member journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary science.
Ototoxicity refers to damage to the inner ear caused by certain drugs or chemicals. Common ototoxic drugs include aminoglycoside antibiotics, loop diuretics, cytotoxic agents, antiprotozoals, antiepileptics, and environmental chemicals. Symptoms of ototoxicity include hearing loss, tinnitus, and balance disorders and can be temporary or permanent depending on the offending agent. Diagnosis involves assessing a patient's exposure history and test results. While there are no treatments to reverse damage, management focuses on rehabilitation and avoiding further ototoxic exposure.
Patients can experience different types of hearing loss, including conductive, sensorineural, and mixed. A history and physical exam including tuning fork tests help distinguish the type of loss. Common etiologies include otosclerosis, presbycusis, noise exposure, and Meniere's disease. Formal audiologic testing is needed to diagnose the condition and guide management, which may include hearing aids, surgery, or lifestyle modifications.
Children who are profoundly deaf fail to develop speech without intervention. Early identification and management of hearing loss before 6 months of age leads to better language development. Causes of deafness can be prenatal, perinatal, or postnatal. Evaluation involves ruling out causes and assessing hearing through objective tests like ABR. Management includes hearing aids, cochlear implants, speech therapy, and special education. Early intervention is important for optimal outcomes.
Auditory neuropathy is a hearing disorder where sound enters the inner ear normally but transmission from the inner ear to the brain is impaired. It can be caused by genetic mutations, infections, or other conditions affecting the auditory nerve. On tests, people with auditory neuropathy have normal otoacoustic emissions but abnormal or absent auditory brainstem responses and acoustic reflexes. Treatment involves hearing aids, cochlear implants, or other assistive devices to provide auditory input and support language development.
This document discusses hearing loss, including definitions, types, causes, examination, diagnosis, and management. It defines different levels of hearing loss based on decibel thresholds. The main types are conductive, sensorineural, and mixed hearing loss. Sensorineural hearing loss is usually permanent and caused by inner ear or nerve damage. Causes include genetic syndromes, infections, trauma, tumors, ototoxic drugs, aging, and noise exposure. Evaluation involves history, physical exam including Weber and Rinne tests, and audiometry. Imaging and labs may be needed depending on history. Management depends on type, but may include hearing aids, cochlear implants, rehabilitation through lip reading and sign language. Rehabilitation of children focuses
rehabilitation of a deaf child (PGIMER CHANDIGARH)abhijeet89singh
This document discusses rehabilitation of deaf children. It defines types of hearing loss and outlines screening protocols for identifying childhood hearing impairment. Investigations for determining the cause of hearing loss are described, including recommended levels of testing. Guidelines are provided for managing and intervening with children who have mild to profound hearing loss, including approaches like hearing aids, remote microphone technology, and cochlear implantation. The importance of ongoing monitoring and family support is emphasized to facilitate a child's development.
Introduction
Epidemiology
Pathophysiology
Sign and symptoms
Complication and investigations
Evaluation
Diagnosis
Prevention and management
Treatment
PrognosisSudden
sensorineural hearing loss
This document discusses evaluation and management of deaf children. It begins by defining different types and degrees of childhood hearing loss. Early diagnosis is important as it allows for early intervention, which research shows improves outcomes for language development and education. Universal newborn hearing screening within the first 3 months of life is now standard practice. Diagnostic tests include otoacoustic emissions testing and auditory brainstem response testing. Causes of childhood hearing loss can be genetic syndromic or non-syndromic causes. Proper evaluation involves history, physical exam, and potential genetic or imaging studies to determine the etiology.
The document discusses various causes and types of deafness in children. It describes inner ear abnormalities like Sheibes dysplasia which affects the cochlea and vestibule. It also discusses different types of hearing loss such as conductive, sensory neuronal, and syndromic hearing loss which occurs with other medical problems. The severity of hearing loss is classified from mild to profound based on loudness thresholds. Potential causes include genetic factors, infections during pregnancy, complications at birth, trauma, and certain drugs. Tests used to evaluate hearing include electrocochleography, acoustic reflex testing, tympanometry and audiometry. Management options involve hearing aids, cochlear implants, and developing speech and language skills.
1) Hearing loss in children can impact language development, academic performance, and social skills.
2) The document estimates that 1 to 3 per 1000 infants and 6 per 1000 children will have permanent sensorineural hearing loss.
3) Early identification of hearing loss before 6 months of age and prompt intervention is important to support auditory brain development and maximize outcomes for children.
This document discusses hearing impairment and cochlear implants. It provides background on a 3-year-old male patient who was born with profound sensorineural hearing loss and was approved for cochlear implantation. The document covers topics like types of hearing loss, impact of hearing loss, who is a candidate for cochlear implants, how implants work, the surgery, and factors that influence success. It emphasizes that cochlear implants are effective for severe-to-profound deafness and require a multidisciplinary team approach including programming, therapy, and parental commitment post-surgery.
Hearing loss ranges in severity from mild to profound and affects 360 million people worldwide. There are three main types of hearing loss: conductive, sensorineural, and mixed. Conductive hearing loss is when sound cannot be conducted through the outer ear to the eardrum. Sensorineural hearing loss is damage to the inner ear or auditory nerve pathway. Mixed hearing loss is a combination of conductive and sensorineural. Signs of hearing loss in children include frequent ear infections, delayed language development, and difficulty locating or identifying sounds. Treatment options depend on the severity and include hearing aids, cochlear implants, and osseointegrated devices.
There are several hearing disorders and conditions that can affect hearing and balance, including auditory neuropathy, central auditory processing disorder, different types of hearing loss, middle ear infections, Meniere's disease, otosclerosis, presbycusis, tinnitus, and tumors of the 8th cranial nerve. These disorders can cause issues with sound transmission and processing, as well as temporary or permanent hearing loss. Treatment options may include hearing aids, cochlear implants, antibiotics, surgery, therapy, and assistive listening devices depending on the specific disorder. Anyone experiencing symptoms of hearing or balance problems should seek help from an audiologist.
This document summarizes various disorders that can cause conductive, sensorineural, and mixed hearing losses. It describes pathologies of the outer, middle, and inner ear that result in these types of hearing loss. Treatment options are discussed for each type and include medical, surgical, and amplification approaches. Disorders covered include otitis externa, tympanic membrane perforations, otosclerosis, Meniere's disease, noise-induced hearing loss, and sudden sensorineural hearing loss.
This document discusses hearing screening in newborns. It begins by defining different types and levels of hearing loss. It then discusses the importance of early identification of hearing loss in newborns through universal screening. Screening can be done using otoacoustic emissions testing or auditory brainstem response testing. Otoacoustic emissions testing evaluates the function of the outer hair cells in the cochlea by measuring sounds produced in response to sound stimuli. Early identification of hearing loss allows for early intervention, which research shows leads to better language development and academic outcomes for children.
This document defines ototoxicity as ear poisoning caused by exposure to drugs or chemicals that damage the inner ear and vestibulocochlear nerve. It lists various drugs and chemicals that can cause ototoxicity, including quinine, salicylates, aminoglycosides, loop diuretics, antiepileptics, and betablockers. Signs of ototoxicity include tinnitus, imbalance, vertigo, and hearing loss. Diagnosis involves a health history, physical exam, electrocochleography, and electronystagmography. Management focuses on limiting ototoxic drugs, periodic exams, hearing aids, vestibular exercises, and treating underlying causes.
The document provides information about deafness/hearing loss, including:
1) It defines deafness and hearing loss, and discusses the anatomy and physiology of the ear.
2) It explains the different types of hearing loss (conductive, sensorineural, mixed, etc), as well as the causes, symptoms, and tests used to diagnose hearing loss.
3) It describes some common treatments for hearing loss, including hearing aids, cochlear implants, earwax removal, and assistive devices. It also discusses the nurse's role in caring for patients with hearing loss.
Learning Outcomes:
Students should be able to:
1) Define deafness2) State the etiology of hearing loss
3) Explain the pathophysiology of hearing loss
4) State the clinical manifestation of hearing loss
5) Explain the types of hearing loss
6) Discuss the investigations of hearing loss
7) Describe the treatment of hearing loss patient
8) Carried out nursing care plan for the patient
It is one of three type of hearing loss
Hearing loss due to defect in the sensory apparatus cochlea (sensory)
Or in the pathway of conduction of nerve impulses to the brain (neural)
Neural causes can be
peripheral:8 nerve
Central:auditory pathway or cortex
Physiology of hearing & approach to hearing loss in a childHareen Chintapalli
The document provides an overview of the anatomy and physiology of the human ear. It discusses the outer, middle and inner ear. The outer ear includes the pinna and ear canal. The middle ear contains the tympanic membrane, ossicles and eustachian tube. The inner ear houses the cochlea which contains hair cells that transduce sound into neural signals via the auditory nerve. The document also describes different types of hearing loss including conductive, sensorineural and mixed, and approaches to assessing hearing loss in children.
This document discusses deafness and hearing impairment. It defines the different types including conductive, sensorineural, mixed, and central hearing impairment. Causes can be inherited, due to infections, loud noises, ageing, or certain drugs. Symptoms include difficulty hearing or understanding speech. Assessment involves hearing tests using an audiometer. Treatment may include antibiotics, steroids, or surgery depending on the cause. Prevention strategies include proper ear care, treating ear infections early, avoiding trauma, monitoring noise exposure and medication side effects, and regular ear exams.
This document provides information about deafness (hearing loss) including:
1. It defines deafness and discusses the anatomy and physiology of the ear.
2. It covers the types (conductive, sensorineural, mixed), causes, signs and symptoms, and investigations of hearing loss.
3. It describes the treatment options for hearing loss including hearing aids, earwax removal, cochlear implants, sign language, assistive devices, and lip reading. It also discusses prevention of hearing loss.
Hearing is the important for the development of speech and verbal communication. Impairment of hearing may be congenital or acquired.
It may be temporary or permanent, organic or inorganic, central or peripheral in origin. Hearing defect can be mild, moderate, severe or profound. It is the most common handicapped conditions in children. It is found about 9 to 15 % among Indian school children.
This document provides an overview of assessment and management of deafness in children and adults. It discusses types of hearing impairment, common causes including genetic factors and infections, methods of evaluation such as audiometry, and interventions including surgery, hearing aids, cochlear implants and education supports. Protecting hearing through preventing infections and excessive noise exposure is also covered.
This document defines key terms related to hearing loss and deafness. It discusses the prevalence of hearing loss globally and in different age groups. Various types of hearing loss are defined including conductive, sensorineural, and mixed. The document also outlines risk factors, pathophysiology, diagnosis, management including medical, surgical, and nursing approaches, as well as rehabilitation strategies.
This document discusses deafness and hearing loss. It defines types of hearing loss such as conductive, sensorineural, and mixed. It outlines causes, risk factors, symptoms, diagnostic tests including Rinne's test and Weber's test, prevention, and management including hearing aids, cochlear implants, aural rehabilitation, and surgery. Nursing care focuses on assessing hearing ability, effective communication strategies, introducing assistive devices, and allowing patients to process their emotions regarding hearing loss.
This document discusses deafness and hearing loss. It defines types of hearing loss such as conductive, sensorineural, and mixed. It outlines causes, risk factors, symptoms, diagnostic tests including Rinne's test and Weber's test, prevention, and management including hearing aids, cochlear implants, aural rehabilitation, and surgery. Nursing care focuses on assessing hearing ability, effective communication strategies, teaching use of assistive devices, and allowing patients to process their emotions related to hearing loss.
The Nucleus Hybrid L24 Cochlear Implant System for sensorineural hearing lossRahul B S
The Nucleus Hybrid L24 Cochlear Implant System is a device approved by the FDA to treat sensorineural hearing loss. It combines a cochlear implant and hearing aid to provide electrical stimulation for high frequencies and acoustic hearing for low frequencies. The internal implant converts sound to electrical signals that are transmitted to electrodes in the cochlea. This helps patients with good low-frequency hearing but poor high-frequency hearing by preserving natural hearing and improving sound perception. While it provides benefits over conventional hearing aids, limitations include inability to transmit rapid sounds and high medical costs.
Deafness (Dr Omokanye) MS LECTURE 2017.pptxSesinuModupe
This document provides information on various types and causes of deafness and hearing loss. It discusses conductive hearing loss, which occurs when sound transmission is impaired in the external or middle ear. Sensorineural hearing loss is caused by abnormalities in the inner ear, auditory nerve or central pathways. Mixed hearing loss has both conductive and sensorineural components. Causes of hearing loss include conditions such as otitis media, noise exposure, certain drugs (ototoxicity), aging (presbycusis), and genetic syndromes. The document also covers classification of hearing loss and approaches to evaluating, diagnosing and managing different types of deafness and hearing impairment.
This PPT is aims to provide knowledge and understanding about the concept of Hearing impairment, Causes of Hearing Impairment, Types of Hearing Impairment, Prevention of Hearing Impairment and Prevalence of Hearing Impairment.
The document discusses the anatomy and physiology of the ear and different types of hearing loss. It describes conductive hearing loss as being caused by issues in the outer or middle ear. Sensorineural hearing loss results from problems in the inner ear or auditory nerve. Mixed hearing loss has both conductive and sensorineural components. Central hearing loss is caused by problems in the auditory nerve or brain centers. Common causes, treatments, and importance of addressing hearing loss are covered.
Deafness Is the leading cause of todays's world.
This topic deals to understand about the types, causes etc if deafness.
It is useful to the nursing students
Noise-induced hearing loss is caused by exposure to loud noises and can be temporary or permanent. It results from metabolic and structural changes to the cochlea from excessive neurotransmitter release and changes to micromechanical structures. Risk factors include a genetic predisposition, age, smoking, diabetes, cardiovascular disease, eye color, and use of recreational or ototoxic drugs. Diagnosis is based on a history of noise exposure and an audiogram showing high-frequency hearing loss with a notch at 4-6kHz. Prevention relies on limiting further noise exposure and using hearing protection.
This document discusses various types and causes of deafness. It defines deafness as a partial or complete loss of hearing. Some key causes mentioned include inner ear damage from infection, disease, loud noise, or age; conditions like Meniere's disease, Ramsay Hunt syndrome, cytomegalovirus infection, bacterial meningitis, sickle cell disease, otosyphilis, Lyme disease, diabetes, thyroid disease, rheumatoid arthritis, tumors, and certain medications like streptomycin. The document also outlines evaluation and treatment options for deafness like physical exams, screening tests, audiometry exams, surgery, hearing aids, cochlear implants, and aural rehabilitation.
Hereditary hearing loss can be caused by genetic mutations and can be passed down from parents to children. The document discusses several types of genetic hearing loss including syndromic hearing loss which is accompanied by other health issues, and non-syndromic hearing loss which only involves hearing. Specific genetic disorders that can cause hearing loss, such as Waardenburg Syndrome and Stickler Syndrome, are explained. Mutations in the GJB2 and POU3F4 genes are highlighted as common causes of non-syndromic genetic hearing loss. The document provides an overview of genetic factors that can contribute to hearing impairment from birth or that develop later in life.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Inner ear disorder
1. HYPERLINK quot;
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Inner Ear Disorder<br /> INNER EAR DISORDERS<br /> Because the inner ear controls balance and hearing, disorders affecting it commonly produce loss of equilibrium, vertigo, nausea and vomiting, and hearing loss. Treatment varies with the disorder and may include drug therapy, surgery, and use of amplification devices.<br /> HEARING LOSS Hearing impairment is... the most common disability in the United States and the third most prevalent in those older than age 65. Mechanical or nervous impediment to the transmission of sound waves can produce hearing loss. The major forms are classified as conductive, sensorineural, or mixed.<br />With conductive hearing loss, sound is interrupted as it travels from the external canal to the inner ear (the junction of the stapes and the oval window). With sensorineural hearing loss, sound wave transmission is interrupted between the inner ear and the brain. The most common type of sensorineural hearing loss, presbycusis, is prevalent in adults older than age 50 and can't be reversed or corrected. Mixed hearing loss combines dysfunction of conduction and sensorineural transmission.<br />Congenital hearing loss can be conductive or sensorineural. Premature or low-birth-weight infants with congenital hearing loss are most likely to have structural or functional hearing impairments; infants with a serum bilirubin level greater than 20 mg/dl also risk hearing impairment from the toxic effects of such a high level on the brain.<br />Because hearing loss is the most common birth defect, the National Institutes of Health as well as numerous other organizations recommend that every neonate be screened for hearing loss, preferably before discharge from the hospital. Early intervention, afforded by early detection, has been proven to help children with hearing loss perform better socially and cognitively as well as in language development than those without early intervention do.<br />Sudden hearing loss, which can occur in a patient with no previous hearing loss, can be conductive, sensorineural, or mixed and usually affects only one ear. Depending on the cause, prompt treatment (within 48 hours) may restore hearing.<br />Noise-induced hearing loss may be transient or permanent. Such hearing loss is common in workers subjected to constant industrial noise and in military personnel, hunters, and rock musicians.<br />Hearing loss may be partial or total and is calculated using the American Medical Association formula: Hearing is 1.5% impaired for every decibel (dB) that the pure tone average exceeds 25 dB.<br /> <br />Causes The most common cause of conductive hearing loss is cerumen (earwax) impaction, which occurs in patients with small or hairy ear canals. Conductive loss may be caused by anything that blocks the external ear (foreign body, edema, or drainage by infection) or by thickening, retraction, scarring, or perforation of the tympanic membrane. Other causes include otitis media, which is common in children and may accompany an upper respiratory tract infection; otitis externa, which results from a gram-negative bacterial infection of the external ear canal; and otosclerosis, which produces ossification of the stapediovestibular joint.<br />Sensorineural hearing loss is caused by impairment of the vestibulocochlear nerve (eighth cranial nerve). The most common form of this type of hearing loss, presbycusis, results from loss of hair cells and nerve fibers in the cochlea or from drug toxicity. Other causes of nerve deafness are infectious diseases (measles, mumps, meningitis), arteriosclerosis, otospongiosis, injury to the head or ear, or degeneration of the organ of Corti. Sensorineural hearing loss may also follow prolonged exposure to loud noise (85 to 90 dB) or brief exposure to extremely loud noise (greater than 90 dB). Occasionally, sensorineural hearing loss results from an acoustic neuroma (a benign tumor that can be life-threatening).<br />Congenital hearing loss, which may be sensorineural or conductive, may be transmitted as a dominant, autosomal dominant, autosomal recessive, or sex-linked recessive trait. Hearing loss in neonates may also result from trauma, toxicity, or infection during pregnancy or delivery.<br />Predisposing factors include a family history of hearing loss or known hereditary disorders (for example, otosclerosis), maternal exposure to rubella or syphilis during pregnancy, use of ototoxic drugs during pregnancy, prolonged fetal anoxia during delivery, and congenital abnormalities of the ears, nose, or throat. In addition, trauma during delivery may cause intracranial hemorrhage and damage the cochlea or acoustic nerve.<br />The cause of sudden hearing loss is unknown. However, the possibilities include occlusion of the internal auditory artery by spasm or thrombosis, subclinical mumps and other bacterial and viral infections, acoustic neuroma, or a single episode of Menie¨re's disease.<br />Sudden hearing loss also may be caused by metabolic disorders, such as hypothyroidism, diabetes mellitus, and hyperlipoproteinemia; vascular disorders such as hypertensive arteriosclerosis; neurologic disorders, such as multiple sclerosis and neurosyphilis; blood dyscrasias, such as leukemia and hypercoagulation; and ototoxic drugs, such as tobramycin, streptomycin, quinine, gentamicin, furosemide, and ethacrynic acid.<br /> <br />Complications If untreated, conductive hearing loss resulting from otitis media can lead to tympanic membrane perforation, cholesteatoma, and permanent hearing loss.<br /> <br />Assessment findings Although congenital hearing loss may produce no obvious signs of hearing impairment at birth, the infant generally demonstrates deficient response to auditory stimuli within 2 to 3 days. In an older child, the patient history may describe a hearing loss that impairs speech development. Rinne and Weber's tests may indicate if the hearing loss is conductive or sensorineural.<br />In a patient with conductive hearing loss, the history may uncover a recent upper respiratory tract infection. Weber's test is positive, and the Rinne test also may be positive.<br />A patient with sudden deafness may report recent exposure to loud noise or brief exposure to an extremely loud noise. The patient may complain of persistent tinnitus and transient vertigo. Audiometric tests indicate that the patient has a loss of perception of certain frequencies (around 4,000 Hz) or, if he has experienced lengthy exposure, loss of perception of all frequencies. Weber's and Rinne tests may indicate conductive or sensorineural hearing loss.<br />In a patient with sensorineural hearing loss resulting from presbycusis, the patient history is probably the most valuable assessment tool because the patient may not have noticed the hearing loss or may deny it. The history also may expose the use of ototoxic substances. Hearing tests reveal a loss that's usually in the high-frequency tones. The patient may report a history of tinnitus. A positive Rinne test may indicate sensorineural hearing loss.<br /> <br />Diagnostic tests Auditory brain response is used to measure activity in the auditory nerve and brain stem. If test results are positive or inconclusive, additional tests may be ordered.<br />A computed tomography scan helps to evaluate vestibular and auditory pathways, and pure tone audiometry is used to assess the presence and degree of hearing loss.<br />Magnetic resonance imaging is used to evaluate brain condition and helps detect acoustic tumors or lesions. Electronystagmography is used to evaluate vestibular function.<br />Otoscopic or microscopic examination can be used to diagnose middle ear disorders or remove debris of infection.<br /> <br />Treatment Treatment for patients with hearing loss varies with the type and cause of impairment and may include medication to treat infections and dissolve cerumen, surgery (stapedectomy, tympanoplasty, cochlear implant, and myringotomy), hearing aids or other effective means of aiding communication, and an antibiotic and a decongestant for hearing loss resulting from otitis media. An analgesic may be given for pain. An antipyretic may be given for fever. A sedative may be given to small children for comfort.<br />Treatment for sudden deafness requires prompt identification of the underlying cause.<br />For noise-induced hearing loss, overnight rest usually restores normal hearing in the patient exposed to noise levels greater than 90 dB for several hours but who hasn't been exposed to such noise repeatedly. As hearing deteriorates, treatment should include speech and hearing rehabilitation because hearing aids rarely help.<br />A cochlear implant may be an option for a patient who's profoundly deaf or extremely hard of hearing. Children and adults can be candidates for insertion of this device. In the United States, 13,000 adults and 10,000 children have received a cochlear implant. This device, which is surgically placed in the skin behind the ear, can provide a sense of sound to help the patient understand auditory stimuli in his environment as well as speech. Whereas hearing aids simply amplify sound, a cochlear implant processes sounds from the environment, converting them to electrical impulses, which are then transmitted to the brain for interpretation.<br />Presbycusis may necessitate a hearing aid.<br />Dietary measures can help to prevent further hearing loss. Studies suggest that people with high cholesterol levels experience greater hearing loss as they age than those with low cholesterol levels do.<br />Nursing diagnoses<br />1. Acute pain<br />2. Anxiety<br />3. Chronic low self-esteem<br />4. Deficient knowledge (diagnosis and treatment)<br />5. Disturbed sensory perception: Auditory<br />6. Fear<br />7. Impaired verbal communication<br />8. Ineffective coping<br />9. Risk for infection<br />10. Risk for injury<br /> <br />Key outcomes<br />The patient will express feelings of comfort.<br />The patient will identify strategies to reduce anxiety.<br />The patient will express positive feelings related to self-esteem.<br />The patient and family will express an understanding of the condition and its treatment.<br />The patient will regain hearing or develop other means of communication.<br />The patient will express feelings and concerns.<br />The patient will effectively communicate feelings and needs.<br />The patient will express his feelings about the disorder and exhibit adequate coping mechanisms.<br />The patient will exhibit no signs or symptoms of infection.<br />The patient will avoid injury.<br />Nursing interventions<br />Answer the patient's questions, encourage him to discuss his concerns about hearing loss, and offer reassurance when appropriate.<br />If the patient has difficulty understanding procedures because of hearing loss, give clear, concise explanations of treatments and procedures. Face him when speaking; enunciate words clearly, slowly, and in a normal tone; and allow adequate time for him to grasp what's expected. Provide a pencil and paper to aid communication, and alert the staff to his communication problem.<br />To speak to a patient who can read lips, approach within his visual range and attract his attention by raising your arm or waving. (Touching him may be unnecessarily startling.) Then stand directly in front of him in a well-lit area, and speak slowly and distinctly.<br />Place the patient with hearing loss in a place where he can observe activities and approach people because such a patient depends totally on visual clues.<br />Encourage the patient who's learning to use a hearing aid because he may experience periods of self-doubt and apprehension about wearing the aid.<br />Refer children with suspected hearing loss to an audiologist or otolaryngologist for further evaluation.<br />Provide the patient and family with opportunities to express their concerns and expectations about the hearing loss. Help them select another mode of communication.<br />Patient teaching<br />Teach the patient and his family about hearing loss, its causes, and its treatments.<br />Explain tests and procedures. For the patient who requires surgery, give preoperative and postoperative instructions.<br />For the patient receiving a hearing aid, demonstrate how to operate and maintain the device, and suggest carrying extra batteries at all times. Remind him that the aid won't restore hearing to a normal level and that it makes speech louder but not necessarily clearer. Encourage him to experiment with the controls for best results. Advise him that lessons in lipreading may increase the effectiveness of the aid. Tell him that if the hearing aid requires repair, he may be able to borrow a substitute from the repair agency.<br />For the patient with temporary hearing loss, emphasize the danger of excessive exposure to noise and encourage the use of protective devices in a noisy environment.<br />If the patient is pregnant, stress the danger of exposure to drugs, chemicals, and infection (especially rubella).<br />Encourage the patient to maintain a low-cholesterol diet, and teach him about foods that are low in cholesterol.<br />If the patient's hearing loss stems from cerumen buildup and the physician has advised ear cleaning or irrigation, demonstrate the proper technique for this and for instilling medication.<br />If the patient has hearing loss resulting from otitis media, discuss the prescribed antibiotic and decongestant and tell him to report any adverse reactions.<br />Review the prescribed medication as well as its proper dosage, administration, and adverse effects.<br />Encourage the patient to tell the physician if he develops a significant earache.<br />LABYRINTHITIS is an inflammation of the labyrinth of the inner ear (which controls both hearing and balance). Labyrinthitis typically produces severe vertigo with head movement and sensorineural hearing loss. Vertigo begins gradually but peaks within 48 hours. Because it may last 3 to 5 days, causing loss of balance and falling in the direction of the affected ear, it may incapacitate the patient. Symptoms gradually subside over 3 to 6 weeks. Prevention is possible through early and vigorous treatment of predisposing conditions, such as otitis media and any local or systemic infection.<br /> <br />Causes Labyrinthitis results from the same organisms (viral or bacterial infections) that cause acute febrile diseases, such as pneumonia, influenza and, especially, chronic otitis media. Viral labyrinthitis the most prevalent form may result from viral illnesses of the respiratory tract, measles, mumps, rubella, or encephalitis. Bacterial labyrinthitis may be caused by otitis media infection or bacterial meningitis. In patients with chronic otitis media, cholesteatoma formation erodes the labyrinth bone, allowing bacteria to enter from the middle ear. Drug toxicity also may cause labyrinthitis.<br /> <br />Complications Meningitis, partial or total hearing loss on the affected side, trauma from falling, permanent balance disability, and decreased quality of life may develop.<br />Assessment findings The patient with labyrinthitis may complain of severe vertigo from any movement of the head, nausea and vomiting, and a unilateral or bilateral hearing loss. Questioning may uncover a recent upper respiratory tract infection. Tinnitus may not be present.<br />On inspection, note spontaneous nystagmus, with jerking movements of the eyes toward the unaffected ear. The patient may also demonstrate excessive giddiness. To minimize these symptoms, he may assume a characteristic posture lying on the side of the unaffected ear and looking in the direction of the affected ear. Examination of the affected ear may reveal purulent drainage.<br /> <br />Diagnostic tests Evaluation of labyrinthitis relies on culture and sensitivity tests to identify the infecting organism if purulent drainage is present, audiometric testing to reveal any sensorineural hearing loss, computed tomography scanning to rule out a brain lesion, and tympanometry and electronystagmography.<br /> <br />Treatment measures are based on relieving the patient's symptoms and include bed rest with the head immobilized between pillows, oral meclizine to relieve vertigo, and massive doses of an antibiotic to combat diffuse purulent labyrinthitis. Oral fluids can prevent dehydration from vomiting; I.V. fluids may be needed for severe nausea and vomiting.<br />When conservative management fails, treatment necessitates surgical excision of the cholesteatoma and drainage of the infected areas of the middle and inner ear. A labyrinthectomy or vestibular nerve section may be done in some patients.<br /> <br />Nursing diagnoses<br />1. Activity intolerance<br />2. Anxiety<br />3. Deficient knowledge (diagnosis and treatment)<br />4. Disturbed sensory perception: Auditory<br />5. Fear<br />6. Risk for deficient fluid volume<br />7. Risk for falls<br />8. Risk for infection<br />9. Risk for injury<br /> Key outcomes<br />The patient will perform activities of daily living to the fullest extent possible.<br />The patient will identify strategies to reduce anxiety.<br />The patient will verbalize an understanding of the condition and its treatment.<br />The patient will regain hearing or develop other means of communication.<br />The patient will express fear and concerns.<br />The patient will maintain normal fluid volume.<br />The patient will identify methods to safeguard his home environment to prevent falls.<br />The patient will remain free from signs and symptoms of infection.<br />The patient will avoid injury.<br />Nursing interventions<br />Answer the patient's questions, encourage him to express his concerns about hearing loss, and offer reassurance when appropriate.<br />If the patient has difficulty understanding procedures because of hearing loss, give clear, concise explanations of treatments and procedures. Face him when speaking;<br />enunciate words clearly, slowly, and in a normal tone; and allow adequate time for him to grasp what's expected. Provide a pencil and paper to aid communication, and alert the staff to his communication challenges.<br />Keep the side rails of the bed up to ensure the patient's safety. Assist with ambulation, as needed, to prevent falls.<br />Maintain the patient on bed rest in a darkened room with his head immobile to reduce symptoms.<br />Give an antiemetic, as ordered, and monitor the patient's response.<br />Monitor blood pressure, turgor, mucous membranes, and pulse for symptoms of dehydration. Provide the patient with oral fluids to prevent dehydration from vomiting. If vomiting precludes oral intake, administer I.V. fluids, as ordered, and monitor intake and output.<br />Patient teaching<br />Teach the patient about the disease and what can be done to treat it and prevent its occurrence.<br />Caution the patient to limit activities, such as driving a motor vehicle or operating machinery, to avoid danger from vertigo.<br />Reassure the patient that recovery is certain but may take as long as 6 weeks. Review the home care checklist. <br />Encourage the patient to seek prompt treatment for upper respiratory tract and systemic infections, particularly for otitis media.<br />Stress the importance of controlling the use of salicylates and other potentially toxic substances.<br />Instruct the patient to complete the prescribed drug regimen. Warn him to discontinue the drug and notify the physician if adverse effects occur.<br />If surgery is required, give the patient preoperative and postoperative instructions.<br />MENIERE'S DISEASE (or endolymphatic hydrops) is an inner-ear problem stemming from a labyrinthine dysfunction. It's associated with increased fluid pressure in the labyrinth. Although it usually affects adults between ages 30 and 60, it may begin at any age. It occurs in both sexes.<br />The disease involves only one ear at first, but about 20% of patients eventually develop problems in both ears. Even with proper treatment, this chronic disease can cause hearing loss.<br /> <br />Causes Menie¨re's disease may result from an overproduction or decreased absorption of endolymph, the fluid within the cochlea and semicircular canals. Pressure from this excess fluid disturbs and damages the sensory cells that transmit hearing and balance perception to the brain.<br />The cause of this overproduction (or underabsorption) is unknown. Various theories attribute the problem to excess sodium retention, an allergic reaction to certain foods, vascular spasms that constrict blood vessels supplying the inner ear, or metabolic, toxic, and emotional factors. These factors may influence the interval of an attack or precipitate an attack.<br /> <br />Complications Menie¨re's disease leads to residual tinnitus and partial to total hearing loss on the affected side, permanent balance disability, trauma from falling, dehydration, and reduced quality of life.<br /> <br />Assessment findings Menie¨re's disease produces three characteristic effects: severe vertigo, tinnitus, and sensorineural hearing loss. Fullness or a blocked feeling in the ear is also quite common. Violent paroxysmal attacks last from 10 minutes to several hours. During an acute attack, other signs and symptoms include severe nausea, vomiting, sweating, giddiness, and nystagmus. Also, vertigo may cause loss of balance and falling to the affected side. To lessen these signs and symptoms, the patient may assume a characteristic posture of lying on the unaffected ear and looking in the direction of the affected ear.<br /> <br />Between attacks, the patient may be free of vertigo. The patient may experience imbalance, unsteady gait, history<br />of falls, inability to maintain an upright position or posture, inability to walk heel to toe on examination, visual changes (blurred vision, diplopia), altered taste or smell, and altered communication. In addition, findings may include hypotension, vomiting or diarrhea, changes in lifestyle, withdrawal, depression, fear, anxiety, and panic. Because these signs can mimic other disorders, diagnostic tests must be performed to confirm the diagnosis.<br />Diagnostic tests Electronystagmography is used to measure the electropotential of eye movements when nystagmus is produced and provides a graphic recording of labyrinthine function.<br />Audiometric tests reveal sensorineural loss and loss of discrimination and recruitment. An auditory brain stem response test helps determine if a cochlear or retrocochlear lesion is causing hearing loss.<br />Magnetic resonance imaging is used to evaluate the structure of the brain and rules out brain lesions or tumors. Laboratory testing must be done to rule out metabolic problems (hypoglycemia or thyroid, lipid, or autoimmune disorders).<br /> <br />Treatment Management of Menie¨re's disease aims to eliminate vertigo and prevent further hearing loss. For an acute attack, the patient may assume whatever position is comfortable. Atropine may stop the attack in 20 to 30 minutes. Dimenhydrinate, meclizine, diphenhydramine, or diazepam may relieve a mild attack. A severe attack may respond to epinephrine or diphenhydramine.<br />Long-term management includes the use of a diuretic or a vasodilator, a vestibular suppressant, labyrinthine exercises, and restricted sodium intake. A prophylactic antihistamine or a mild sedative may also help. Some 75% of patients respond to a salt-free diet and the use of a diuretic. However, diuretic efficacy hasn't been proved. Avoiding tobacco, alcohol, and caffeine may be recommended. For the anxious and fearful or depressed patient, a psychological evaluation is indicated.<br />If the disease persists after more than 2 years of treatment or produces incapacitating vertigo, the patient may require surgery. Some patients benefit from endolymphatic sac decompression (endolymphatic shunt). This procedure creates an opening in the labyrinth to drain excess fluid from the ear. A more complex procedure resects the vestibular nerve, which carries impulses from the mechanisms involved with position sense in the inner ear to the brain. If the patient has severe hearing loss in one ear, radical labyrinthectomy may be helpful.<br />Systemic streptomycin is reserved for patients in whom the disease is bilateral and no other treatment can be considered.<br /> <br />Nursing diagnoses<br />1. Acute pain<br />2. Anxiety<br />3. Deficient fluid volume<br />4. Disturbed sensory perception: Auditory<br />5. Fear<br />6. Hopelessness<br />7. Imbalanced nutrition: More than body requirements<br />8. Ineffective coping<br />9. Powerlessness<br />10. Risk for falls<br />11. Risk for injury<br /> <br />Key outcomes<br />The patient will express feelings of comfort.<br />The patient will identify strategies to reduce anxiety.<br />The patient will maintain adequate fluid balance.<br />The patient will regain hearing or develop other means of communication.<br />The patient will express fears and concerns.<br />The patient will participate in decisions about care.<br />The patient will identify appropriate food choices according to his prescribed diet.<br />The patient and his family will seek appropriate support groups to assist with coping.<br />The patient will express feelings of control over well-being.<br />The patient will identify strategies to safeguard his home environment to prevent falls.<br />The patient will avoid injury.<br />Nursing interventions<br />If the patient experiences an attack in the facility, keep the bed rails up to prevent falls. Don't let the patient rise or walk without help.<br />Answer the patient's questions, encourage him to express his concerns about hearing loss, and offer reassurance when appropriate.<br />If the patient has difficulty understanding procedures because of hearing loss, give clear, concise explanations of treatments and procedures. Face him when speaking; enunciate words clearly, slowly, and in a normal tone; and allow adequate time for him to grasp what's expected. Provide a pencil and paper to aid communication, and alert the staff to his communication challenges.<br />Before surgery, if the patient is vomiting, record fluid intake and output and characteristics of vomitus. Administer an antiemetic, as ordered, and frequently give small amounts of fluid.<br />After surgery, carefully record intake and output.<br />Give a prophylactic antibiotic and antiemetic, as ordered, and monitor the patient's response.<br />Help the patient to identify successful coping behaviors.<br />Teach the patient about his diagnosis and treatment.<br />Stress the importance of maintaining his activity level and exercising regularly.<br />Patient teaching<br />Review a low-sodium diet with the patient. Discuss foods and nonprescription drugs that contain sodium.<br />Instruct the patient about the prescribed diuretic and vasodilator. Tell him to report any adverse reactions.<br />Advise against reading and exposure to glaring lights to reduce dizziness.<br />Instruct the patient to avoid sudden position changes and any tasks that vertigo makes hazardous, because an attack can begin rapidly.<br />Because stress and fatigue can trigger attacks, teach the patient relaxation and stress management techniques. Review ways to modify the patient's lifestyle, including making adequate time for rest and relaxation.<br />After surgery<br />Tell the patient to expect dizziness and nausea for 1 to 2 days.<br />Because Bell's palsy is a complication of surgery, instruct the patient to be alert for possible signs and symptoms, such as facial numbness and tingling and incomplete eye closure.<br /> <br /> <br />