EXTERNAL EAR DISORDERS
👂 OTITIS-EXTERNA (Otitis externa)
🧡 DEFINE OTITIS-EXTERNA
► Otitis externa is an infection and inflammation of the external ear (ear lobe, external auditory canal, outer ear).
► Otitis externa is also called as swimmers ear. Because it is more common to fill the ear with water after swimming and otitis externa is more common in summer than winter.
► In this there is inflammation in the skin lining of the external auditory canal. It can be acute or chronic (acute:= means for a short time, chronic:= means for a long time).
🧡 WRITE CAUSES OR ETIOLOGY OF OTITIS EXTERNA
Ear irrigation after swimming.
Any trauma to the external ear.
Bacterial infections such as Pseudomonas species,
Gram negative rods (gram negative rods),
It is Staphylo coccus species (staphylococcus species).
Fungal infections such as Aspergillus species (aspergillus species),
Candida species (candida species).
eczematous dermatitis.
Any skin infection of face, neck or scalp.
Having an infection or inflammation of the middle ear.
🧡 RISK FACTORS FOR OTITIS EXTERNA
Excessive Moisture: Prolonged exposure to water or moisture in the ear can create a favorable environment for bacterial or fungal growth. This is why otitis externa is often referred to as swimmer’s ear.
Trauma to the Ear Canal: Scratching with objects such as cotton swabs or hairpins can damage the delicate SKIN, which becomes a portal of entry for infection.
Allergies: Allergic reactions can cause inflammation in the ear canal, making it more susceptible to infection.
Immunosuppression: Conditions or medications that weaken the immune system, such as diabetes or certain medications, can increase the risk of infections, including otitis externa. (may increase risk.)
Cuts or Abrasions: Any break in the skin of the ear canal, whether due to injury or irritation, can provide an entry point for bacteria or fungi.
Swimming in Contaminated Water: Swimming in water that is contaminated with bacteria or fungi can introduce these microorganisms into the ear canal.
Humid Environments: Living in a humid climate or regularly exposing the ears to high humidity can contribute to the development of otitis externa.
🧡 WRITE SIGN AND SYMPTOMS OF OTITIS EXTERNA
Ear Pain: One of the most common symptoms is pain, which can range from mild discomfort to severe, sharp pain. The pain is often exacerbated by movement of the outer ear or by pulling on the earlobe. (One of the most common symptoms is pain, which can range from mild discomfort to severe, sharp pain. The pain is often exacerbated by movement of the outer ear or by pulling on the earlobe.)
Redness and Swelling: The ear canal may appear red and swollen, and the outer ear may be tender to the touch. The inflammation contributes to the discomfort associated with the condition. The ear canal may appear red and swollen, with tenderness).
itching,
swelling,
watery discharge,
crusting, scaling,
The skin is very thick.
Drainage from the ear is yellow, green and foul smelling.
Hearing loss occurs.
fever.
🧡 WRITE DIAGNOSIS OF OTITIS EXTERNA
► History taking and physical examination
► Inspection of Ear
► Whisper test- Whisper test
► otoscopic examination-otoscopic examination
🧡 WRITE MANAGEMENT OF OTITIS EXTERNA
★ Ear Cleaning/Irrigation: Ear irrigation is done to clean the external auditory canal and remove debris, any impacted wax, or foreign bodies.
Topical Medications: Antibiotic ear drops or corticosteroids are used to treat ear inflammation. Ex: ciprofloxacin-dexamethasone, Neomycin, Hydrocortisone, Polymyxin B, etc. Fungal infections are treated with topical antifungal agents such as nystatin. Topical corticosteroid creams or lotions are used.
★Pain Management: To remove the patient’s pain ie pain, its therapeutic drugs are used.EX.NSAID-ACETAPHENOMEN
★ Prescription Medications: If the infection is severe, the doctor may prescribe oral antibiotics or antifungal medications.
★ Warm Compress: Applying a warm compress to the affected ear can help reduce pain and inflammation.
🧡 WRITE NURSING MANAGEMENT OF OTITIS EXTERNA
Assessment ::
Obtain a detailed medical history, including recent water exposure, ear injury, or use of hearing aids (headphones, hearing aids). Assess for signs and symptoms of otitis externa such as ear pain, itching, redness, swelling, discharge, and hearing loss. Assess the patient’s overall health, immune status, and any underlying conditions that may contribute to infection.
Applying any medicated ointment or powder to the patient for local treatment. Instill prescribed topical eardrops, which often contain antibiotics (eg, neomycin, polymyxin B, hydrocortisone).
Provide warm compression to the patient.
Apply cold application to relieve inflammation and discomfort.
Administering analgesic drugs to relieve the patient’s pain.
Administering antibiotic medicine to the patient.
Maintain aseptic technique to avoid any further infection.
Monitoring and Evaluation: Regularly assess the patient’s response to treatment, including changes in symptoms and signs of improvement. Monitor for any adverse drug reactions
Advising the patient to take proper care and follow up.
🧡 PREVENTION OF OTITIS EXTERNA (Prevention of Otitis Externa)
★ Avoid Irritants:
Avoid exposure to irritants such as hair spray, hair dye and other chemicals that can worsen the condition.
★ Keep the Ear Dry:
Avoid swimming or submerging the affected ear in water until the infection has cleared.
Use a water-resistant earplug or cotton ball coated with petroleum jelly when showering or bathing to prevent water from entering the ear.
Tell the patient to avoid exposure to water.
Tell the patient not to insert any instrument into the ear such as cotton buds.
Tell the patient not to allow any excess ear wax to accumulate in the ear and visit the doctor properly.
If a patient already has an ear infection or a hole in the ear drum or has undergone any type of ear surgery, consult a doctor before swimming or using any other ear drops.
Use mineral oil ear drops to remove any kind of dry crust in the ear.
Do not put any kind of hair pin or ear birds in the ears.
Get a doctor’s proper ear examination.
👂 FOREIGN BODY
Introduction
A foreign body in the ear, such as any small object that gets lodged in the ear, is called an emergency. The foreign body is accidentally drifted into the ear and the patient is not even aware of it.
In adults (flies, mosquitoes, ants, cockroaches etc. flow into the ears), In children (chocolate, small pieces of any vegetable, pulses, chingam, leaves, flowers, pieces of cloth, small toys, pencil eraser, etc. in the ears of small children but flows).
clinical manifestation
ear pain,
Uncomfortable feeling in the ears,
itching,
Vibration fills the ear,
Hearing is reduced in the affected ear,
There is an ear infection.
ear pain,
Bleeding from the ears.
First aid
A foreign object causes pain and hearing loss in the ear and if this object gets stuck in the ear it hurts a lot but children are not aware of it.
When it seems that any foreign object has drifted into the ear, do not insert any kind of ear birds or hair pins into the ear as this will further push the foreign body into the ear and damage the middle ear.
If any foreign body is visible, try to remove it slowly.
Using the force of gravity means turning the affected ear towards it and slowly trying to remove the foreign body.
If there is any insect in the ear, put a little warm oil or olive oil so that if there is insect, it comes out of the ear and if there is a perforation in the ear drum, do not put the oil in the ear and take medical advice and go to the doctor.
Removal of foreign body
Removing a foreign body from the ear is very important in the emergency department.
Kill any foreign body with mineral oil or lidocaine (2%) before removing it.
Foreign body removal includes mechanical extraction, irrigation, suction and medication.
1) mechanical extraction:=
This involves placing the patient in a comfortable position.
Repeated ear examination and checking the depth of the foreign body.
Then insert the lens of the otoscope and introduce the bayonet forceps from the other side.
Insert the forceps slowly until the foreign body is grasped.
Then when the foreign body is grasped, slowly remove the forceps and take out the forceps slowly so as not to cause any injury to the auditory canal and ear drum.
To see if the foreign body is completely removed or not.
Also look for any injury to the tympanic membrane.
irrigation
Irrigation is a simple method to remove any foreign body.
Inserting the water slowly from above or from the front side of the ear.
Ear irrigation is contra-indicated for any soft object, organic matter, any seed.
suctioning:=
Holding the tube in contact with the foreign object and suctioning.
Any foreign object is then grasped by the alligator forceps.
The foreign object is then removed.
Thus the foreign object is also removed by Saksan.
medication
There is no medicine for any foreign body but if there is any kind of infection or abrasion then combination of antibiotic and steroid is used.
management
Giving reassurance to the patient.
Do not remove the foreign object with any sharp object as it may rupture the panicked team member.
If a foreign object remains inside the ear, lower the affected ear over the shoulder on that side and try to slowly remove the foreign object.
war. Use water and fluid to flush out any insects.
Put some oil inside the ear so that any insect, if any, swims out.
If it is difficult to get it out, consult a doctor.
Do not insert any objects into the ears such as earrings, hair pins, and any sharp objects.
If the foreign body is visible from outside, do not irrigate it as it increases in size and gets impacted in the ear.
Impacted cerumen
introduction
Cerumen impaction is a condition in which ear wax gets blocked inside the tightly external auditory canal.
This develops when ear wax becomes blocked inside the ear canal and blocks the ear drum.
If the earwax gets blocked inside the ear canal, it causes the problem.
Ear wax is also called cerumen.
Ceriumen is a mixture of serous and sebaceous glands containing epithelium and dust particles.
Earwax protects the ear against infection and keeps the ear clean by trapping any dust particles.
Etiology
Impacted cerumen occurs when earwax is pushed through cotton tips, impacted cerumen occurs when earwax is pushed into the ear by hairpins or other objects.
In this, wax accumulates even when there is an excessive production of wax by the ear gland.
Sheruman is also impacted when the ear is not cleaned properly or is older age and has a lot of hair in the ear.
clinical manifestation
Difficulty hearing,
Itches
hurts,
A tinnitus-like sound is heard in the ears
dizzy,
Feels like fullness in ears,
discomfort in the ears,
ear pain,
Hearing loss occurs.
treatment
A) irrigation of ear,
B) Removal with curette,
C) suctioning.
A) Irrigation of ear:=
Irrigation is the most common method for removing any impacted wax.
In this the ear canal is washed with water and a commercial irrigator syringe.
The pressure and force of the water softens the earwax.
The doctor adds a small amount of alcohol, hydrogen peroxide, and another antiseptic.
After ear irrigation, the doctor applies antibiotic ear drops to protect against infection.
B) Removal with curette:=
A Jobson Horne curette is used in a circular motion to break up the earwax.
A cotton tipped or applicators are used to remove the earwax.
C) Suctioning:=
If the ear wax has become too occluded, a large bore (large born suctioning) device is used to remove the earwax.
The procedure to remove earwax by suction is very painful so ask the patient to instill ear drops for two weeks after suction.
management
Sherum is removed by irrigation, drainage, and instrumentation.
If the earwax is not too tightly packed, irrigate slowly and remove the impacted wax.
Earwax is removed by water.
Direct visual or mechanical removal is performed if irrigation is not successful.
A few drops of glycerine and mineral oil and half of hydrogen peroxide in the ear canal and left for 30 minutes will soften the earwax and then it is easy to remove.
If cerumen is not dislodged properly, instruments like cerumen curette aural suction and binocular microscope are used.
And ask the patient to follow up properly
otalgia
introduction
Otalgia may be defined as a pain in the ear or earache.
Etiology
Due to bacterial contamination and insertion of any fingers or toes.
Due to inserting any sharp object.
Due to swimming in any polluted water,
Due to any upper respiratory tract infection.
Infection due to any foreign body such as any insect, food grain, toy, etc. being inserted.
clinical manifestation pain,
A Sense of Fullness,
itching,
be informed,
difficulty hearing,
bleeding,
Very painful in the ears.
management
Irrigation of the ear.
Do not irrigate if there are any vegetables or insects as there are chances of swelling.
witnessing,
Instillation of mineral oil as it kills the insect and removes it from the ear.
Sometimes it is necessary to remove the foreign body even by giving anesthesia.
furenculosis
introduction
Furunculosis is an infection and inflammation of the hair follicles in the external auditory meatus caused by infection with staphylococcus bacteria.
clinical manifestation
very painful,
swelling,
There is difficulty in hearing for some time.
discomfort,
Tenderness,
fever,
headache,
ear pain,
drainage from the ear,
Redness occurs,
Swelling occurs.
management
Administering analgesic medication to the patient to relieve pain.
Administering antibiotics to the patient,
Provide warm compression to the patient to relieve swelling.
Provide warm compression to the patient to relieve discomfort.
Incision and drainage.
Provide health education to the patient and his relatives to prevent ear infection and take proper care of the ear.
Ask the patient to follow up properly.
Dieses and disorder of the middle 👂 Ear
otitis media (otitis media)
Infection and inflammation of the middle ear is called otitis media.
“Otitis” means:=inflammation*of the Ear.
“Media”
Means :=middle.
This inflammation is caused by a sore throat, cold or other upper respiratory tract infection.
track infection) spreads from there to the middle ear and it can be due to virus or bacteria and can be acute and chronic.
In it, acumination of fluid occurs in the middle ear and due to this, bulging occurs and it causes pain.
type
1) Acute otitis media.
2) Chronic otitis media.
Etiology
Streptococcus bacteria,
Haemophilus influenzae,
upper respiratory tract infection,
exposure to air with irritants such as tobacco smoke 🚬,
client with cleft palate or down syndrome.
clinical manifestation
Children who have had otitis media are irritable,
Children who have otitis media have problems in feeding and sleeping.
hurts,
Ear feels like fullness,
fever,
sign of upper respiratory track infection such as runny or stuffy nose 👃 or cough.
Pus collects in the ear and causes pain.
Rupture the eardrum.
Collection of pas takes place in the middle year.
management
antibiotics,
observation,
surgical management including myringotomy or tympanotomy.
Nursing management
Nursing assessment
To assess whether the patient has upper respiratory tract infection or not.
See if the patient complains of any numbness or not.
To see if the patient has earache or not.
Observe whether the patient hears a ringing sound in the ear.
Observing whether the patient feels uncomfortable or not.
Observe whether the patient has nausea and vomiting.
Nursing Diagnosis
1) Anxiety related to unpredictability of sudden and severe attacks.
2) fear related to potential permanent hearing loss.
3) ineffective role performance related to impaired equilibrium.
4) Impaired social interaction related to communication barriers.
5) Risk for injury related to impaired equilibrium.
6) Fluid volume deficit related to 😵 and vomiting 🤢.
Nursing interventions
Assessing the patient’s pain level.
Observe the patient for any discharge from the ear.
Proper drainage of ear secretions.
Checking the patient’s middle ear pressure.
Treating the etiology of otitis media.
Cleaning the ear by flushing with normal saline.
To apply antibiotic ear drops to the patient.
Provide complete bed rest to the patient.
Introduction
Acute otitis media is also called acute suppurative otitis media or purulent otitis media.
Acute otitis media is an acute infection and inflammation.
It has an immediate onset and a short duration.
In this, acute infection occurs in the middle ear and is within six weeks (6 weeks).
Etiology (causative organism)
most common cause upper respiratory tract infection.
pneumococcus species,
Haemophilus influenza, (Haemophilus influenza.),
Morraxell catarhalis (Morraxell catarrhalis),
streptococcus pneumonie ( Streptococcus pneumoniae).
Risk factors
A baby is premature or has a low birth weight,
have a family history,
have altered immunity,
crsniofacial
abnormality,
neuromuscular disease,
A person with seasonal allergies,
A person has tonsillitis,
having a deviated nasal septum,
Nozma Tumor,
Having a left palate or Down syndrome,
The tympanic membrane has a perforation,
vitamin a, zinc, and iron deficiency,
measles, diphtheria and whooping cough,
Frequent upper airway infections
A children’s bottle fitting,
Low socio economic condition,
Exposure to tobacco or pollutants.
clinical manifestation
earache,
Blood vessels engorgement,
Swelling of the mucous membrane,
develop serous exudate,
sensation of fullness,
Fever,
ringing in the ears,
drainage from the ear,
Exudate from ear due to rupture of ear drum.
difficulty hearing,
Irritability of the patient,
The patient feels tenderness,
headache,
Insomnia of the patient,
Nausea, vomiting and diarrhoea,
Difficulty speaking,
Collection of pus in the ear.
Diagnostic evaluation
history taking and physical examination,
otoscopy examination,
pure tone audiometry,
whispered speech test,
weber test,
rinne test.
management
medical management
Providing analgesic medication to relieve the patient’s pain,
Administering antipyretic medicine to reduce the patient’s fever,
Administering antibiotic medicine to the patient,
Ask the patient to take complete bedrest,
Instillation of warm eardrops in the patient’s ear,
To provide medicine to the patient as per his requirement.
surgical management
If there is fluid collection in the middle ear
Myringotomy (making an incision in the tympanic membrane.) or
Tympanotomy is done and drainage of fluid is done.
Aspirating fluid from the ear and sending it to the laboratory for culture.
Place a cotton swab loosely in the external ear and collect the drainage.
When cottons become wet through pus, change them frequently to prevent secondary infection.
Cotton swabs are infectious so wash your hands frequently after changing them.
Apply antibiotics for a few days when the discharge from the ear stops.
If the patient’s body temperature increases, the patient complains of headache, he feels very sleepy, the patient is irritable and
Inform doctor immediately if disoriented.
All parents can do to prevent otitis media is to seek immediate medication or medical attention when a child complains of ear pain.
Continue antibiotics for a few days when signs and symptoms of otitis media have resolved.
introduction
Chronic otitis media is also called chronic suppurative otitis media.
Chronic suppurative otitis media is a long-term infection of the middle ear and causes ear tissue damage, and chronic otitis media is caused by repeated episodes of acute otitis media.
Chronic otitis media is caused by the accumulation of fluid in the middle ear.
And middle ear infection also has involvement of mastoid bone.
Etiology (causes)
Streptococcus (Streptococcus),
staphylococcus,
pseudomonas organisam (Pseudomonas infection),
perforation of eardrum,
poor socio economic condition,
overcrowding,
poor nutrition,
poor hygiene,
chronic sinusitis,
repeated episodes of acute otitis media.
clinical manifestation
difficulty hearing,
pain,
dizziness,
foul smelling,
tenderness,
Meningitis, (infection and inflammation in the meningeal layer of the brain),
A collection of abscesses in the brain,
facial paralysis,
fullness of ear,
hearing loss,
Having problems in balance,
dizziness,
headache,
facial weakness,
Fever,
sleeplessness,
tendence of mastoid process,
Ear mucous red,
Edema and swelling.
Diagnostic evaluation
history tacking and physical examination,
otoscopic test,
whisper test,
weber test,
run test,
pure tone audiometry,
elecronystegmography.
management
medical management
antibiotic medicine,
Analgesic medicine,
antipyretic medicine,
surgical management
myringoplasty (myringoplasty):=
This involves removing the tympanic membrane defect using an operating microscope.
myringootomy (myringootomy):=
A small incision is made in the tympanic membrane and the fluid collected inside the tympanic membrane is drained.
tympanoplasty (tympanoplasty):=
Tympanoplasty is intended to repair the perforated ear drum and not the middle ear bones such as malleus, incus, stapes.
tympanocentesis ( tympanocentesis):=
In this, the needle is inserted through the anterior part of the tympanic membrane and the contents of the middle ear are aspirated and sent for culture.
ossiculoplasty (ossiculoplasty):=
In ossiculoplasty, surgical reconstruction of the middle ear bone is done. Laser surgery is also done to improve hearing if the stapes bone is damaged.
If cholesteatoma has occurred.
Mastoidectomy:=
This includes incision, drainage, and surgical repair of the mastoid process if there is mastoiditis over the mastoid bone.
simple mastoidectomy:=
In this the surgeon makes an incision behind the ear and the infected area is removed.
radical mastoidectomy (radical mastoidectomy) :=
In this, all diseased conditions of the middle ear are removed.
And its structure is removed.
It also involves removing the entire tympanic membrane and ossicles (mallus, incus, and stapes) bones and closing the opening of the eustachian tube.
cortical mastoidectomy Cortical Mastoid Dektomy):=
This operation is also called Schwartze operation.
modified radical mastoidectomy (modified radical mastoidectomy):=
In this the ossicles and tympanic membrane are preserved for reconstruction of hearing.
Nursing management
1) Pain related to inflammation and pressure on tympanic membrane.
Nursing interventions
Relieving pain
Assessing the location of the patient’s pain, its intensity and frequency.
Observation of the ear canal for any kind of inflammation and swelling.
Assess the tympanic membrane for any redness, bulging or bubbles.
Provide analgesic to the patient.
Using analgesic ear drops.
Ask the patient to sit up, raise the head and lie on the unaffected area.
Keep the head up.
Applying a heating pad to the patient increases blood supply and relieves discomfort.
2) Risk for infection* related to* eustachian tube Dysfunction.
preventing infections:=
Taking a complete history from the patient like previous ear infection, water exposure or allergy exposure or use of earphones or hearing aids.
Asking the patient about his symptoms such as ear pain, hearing loss, and taking a complete history of dizziness.
Performing an otoscopic examination of the patient.
Any type of drainage or debris from the ear canal or its color if any
Checking the appearance of the tympanic membrane and the amount of fluid drainage.
Provide the patient with antibiotic antipyretic and anti-inflammatory drugs to reduce infection and inflammation.
Examination of the ear 3 to 4 days after completion of antibiotic treatment to check whether any further treatment is required.
To remove any infectious agent or irritant material like tobacco, smoke, dust, allergen etc.
Ask the patient to take proper nutrition and also ask to rest and exercise.
Educate family members to cover their mouth and nose when sneezing and coughing as good hygienic conditions are essential to prevent infection.
3) Impaired verbal communication related to hearing deficit.
improvimg hearing and communication:=
Checking the patient’s hearing ability.
Bring the patient to a well-lit area and ask him to keep his hands away from his mouth.
Do not ask the patient to speak too loudly.
Be honest with the patient.
Tell the patient to speak in simple words and in plain language and slowly.
Using other methods to communicate like computer writing tools etc.
To prepare the patient for ear surgery.
Tympanoplasty and mastoidectomy are common surgical treatments for hearing loss.
4) Fear and anxiety related to progression of disease.
Education / *continuity of care.
Teaching the patient or caregiver to administer the medicine.
Administer ear drops at room temperature.
Do not let the tip of the applicator or the tip of the drop come into contact with the ear.
Positioning the head in such a way that the flow of ear drops does not go into the ear canal properly. Keep this position for one to two minutes
Teaching how to properly clean the ears.
A damp cloth and finger is the best method to clean the ear.
Applying a cotton finger in the ear cleans the ear properly.
Minimize use of technology like telephone, TV etc.
Educate the patient to perform routine ear examination
introduction
Mastoiditis is an inflammation of the mastoid cellular system which is the area behind the ear.
In mastoiditis, infection occurs in the space of the mastoid bone where the air containing space is located.
Mastoiditis occurs mainly as a complication of otitis media.
A cute mastoid diitis is caused by acute otitis media.
And chronic mastoiditis is mainly due to chronic suppurative otitis media.
Etiology (causes)
most common cause otitis media.
Streptococcus pneumoniae (Steptococcus pneumoniae),
pseudomonas aeruginosa (Pseudomonas aeruginosa),
haemophilus influenzae (Haemophilus influenzae),
moraxilla catarrhalis ( Moraxilla catarrhalis),
mycobacterium species,
Pneumococcus (Pneumococcus)
clinical manifestation
Pain behind the ear.
Tenderness is felt in the mastoid region.
Swelling or swelling occurs in the mastoid region.
ear pain,
Masteroid process causes redness,
fever,
headache,
Nausea and vomiting occur.
dizzy,
There is difficulty in hearing.
Discharge from the affected ear,
Formation of pus takes place.
formation of abscess,
The drainage of the bus comes out of the infected ear.
Redness swelling behind the ear.
Diagnostic evaluation
history taking and physical examination.
Computed tomography test,
laboratory investigation
medical management
antibiotics,
Antipyretic
surgical management
mastoidectomy
In this surgical removal of the infected mastoid cell is performed, the surgeon makes an incision at the back of the ear to reach the mastoid region and remove the infected air cell.
tympanostomy tube insertion
In this, a tube is inserted and pus is drained from the middle ear, due to which the infection can be treated.
Nursing management
1) Anxiety related to surgical procedure potential loss of hearing, potential taste disturbance,
And potential loss of facial movements.
Reducing Anxiety:=
Building a therapeutic relationship with the patient.
Communicate with the patient in such a way that he can describe his anxiety and his feelings.
Asking the patient to keep their mental stress away.
Reassurance to the patient.
Providing psychological support to the patient.
2) Acute pain related to mastoid surgery.
relieving pain :=
Assessing the patient’s pain level.
Administering the prescribed analgesic medication to the patient.
Providing Mind Divergent Therapy to the patient.
Ask the patient to take proper bed rest.
Ask the patient to drink more fluids.
To maintain the nutritional status of the patient.
3) Risk for infection related to masoidectomy, surgical trauma to surrounding tissues and structures.
preventing infections:=
Take immediate steps to prevent infection.
Use of antibiotic solution when placing packing in external auditory canal.
Instillation of antibiotic ear drops to the patient.
Tell the patient to prevent water from getting into the ear.
Place a cotton ball with petroleum jelly loosely in the ear.
To see if the patient has any kind of infection.
Maintain hygienic condition of patient.
Wash hands properly before doing any procedure.
Maintain aseptic technique while handling the patient.
Place the patient in a well-lit environment.
pre operative and post operative Nursing management:=
pre operative Nursing management:=
Preoperative audiogram and tympanogram to assess hearing acuity.
Provide a comfortable position to the patient.
Advise the patient to keep the ear dry.
Tell the patient not to insert any objects such as earbuds or hairpins into the ears.
Tell the patient not to make sudden movements.
Tell the patient not to blow the nose as secretions from the nose can reach the middle ear through the Eustachian tube.
Providing local or systemic antibiotics to the patient.
Providing analgesic medicine to the patient.
Administer steroid nasal drops to the patient to prevent infection and inflammation.
Provide psychological support to the patient to prepare you and him for surgery.
Teaching the patient and his family members about surgery and post-operative care.
post operative care:=
Provide complete bed rest to the patient for 24 to 48 hours after the operation.
Check dressing should be slightly tight and proper to absorb drainage.
Change the dressing daily.
To see if the patient has any facial paralysis.
Observe the patient for headache, vomiting, stuffy neck, dizziness, irritability, or disorientation.
There is a chance of chronic purulent otitis media after the operation so provide proper antibiotic medicine.
To check patient’s vital signs properly.
Maintaining the patient’s fluid level.
Tell the patient and his relatives to maintain the patient’s hygiene condition.
Administer antihistamine medicine and analgesic medicine to the patient.
Ask the patient to follow up properly.
Perforation of Ear 👂 drum (Perforation of Ear Drum)/ tympanic membrane perforation.
introduction
A perforation (hole) is formed in a perforated eardrum.
And this hole damages the middle and inner ear and also causes infection.
Conductive hearing loss can also occur due to perforation of the ear drum.
Perforation in the ear drum causes hearing loss and occlusal discharge.
cause/Etiology
Perforation can also occur due to direct injury to the ear drum.
Any foreign object or sharp blow can also cause perforation of the ear drum.
Due to the insertion of any hair pins or even ear birds.
💀 Even after skull facture.
Due to exposure to too much loud voice.
infection,
Due to not doing curettage by syringe of proper manner.
due to trauma.
due to fall.
clinical manifestation
ear pain,
Drainage comes out of the ear.
have difficulty hearing,
dizzy,
disoriented,
fullness of ear 👂,
A ringing sound is heard in the ears.
Bloody discharge from the ear.
Diagnostic evaluation
history taking and physical examination
direct inspection with an otoscope.
management
A perforated ear drum heals on its own within one to two months.
Providing antibiotic therapy to the saint,
Maintain aseptic technique to avoid excessive infection.
Placing packing in the ear drum.
If the ear drum does not heal on its own, surgical correction is necessary.
Ask the patient to maintain hygienic condition of ear.
Provide analgesic medicine to the patient.
If the perforated ear drum is due to foreign objects, do not try to remove it yourself and seek the help of a medical professional.
surgical management
Certain types of large holes and small holes require surgery.
The surgery is performed under general anesthesia.
1) Tympanoplasty :=
In this the perforated ear drum is surgically corrected.
2) myringoplasty:=
In this the perforated eardrum is surgically closed.
3) occiculoplasty:=
This involves a surgical procedure in which the ossicles are surgically reconstructed.
prevention
Ear infection should be treated immediately.
Do not put any kind of objects in the ear to clean the ear.
Wear proper ear protection.
Disease and disorder of the internal ear 👂
presbycusis
introduction
He has hearing loss due to age
Presbycusis
(presbycusis) is called.
We at PressBuyCounts
(presbycusis) is more common in people above 65 years of age.
One of the main causes of this age
There is a disorder.
Presbycusis occurs slowly and occurs in both ears but many people are not aware of it.
Etiology/ cause
due to ambient noise.
Due to sensory receptor damage in the inner ear.
inherited from generation to generation,
Due to age,
Due to certain health conditions like diabetes and hypertension,
Due to the side effects of certain medications such as aspirin and certain types of antibiotics.
symptoms
One cannot hear properly,
High pitched sounds such as “s” and “th” are difficult to distinguish.
It is difficult to understand a conversation when there is background noise.
Men’s voices are easier to hear than women’s.
A tinnitus-like sound is heard in the ears.
Hearing is very difficult.
treatment for presbycusis
Avoid going to places where there is too much noise or exposure to loud noise.
Wiring the ear plugs into the ears.
Using hearing aids.
Using telephone amplifiers,
Training someone to understand what they are saying
introduction
Labyrinthitis is an inner ear disorder in which infection and inflammation occurs in the inner ear called labyrinthitis.
Labyrinthitis affects balance and hearing.
It is seen in one or both ears and its hallmark symptom is vertigo.
Etiology/ cause
Due to infection in another part of the body such as otitis media and meningitis.
Due to some type of infection.
Due to head injury.
Due to taking too much stress.
Due to some type of allergic condition.
Due to consuming too much alcohol.
Due to taking certain types of medicines such as aspirin.
Labyrinthitis can also be caused by an infection in the upper respiratory tract.
Also caused by viruses and bacteria.
Risk factors
Drinking too much alcohol.
Have any allergies.
Have an upper respiratory tract infection.
smoking,
Taking too much stress,
Taking certain prescription or over-the-counter medications such as aspirin.
type
1) DIFFUSE SEROUS LABYRINTHITIS
This type of labyrinthitis is acute.
And is often caused by drinking alcohol.
And due to certain types of allergic conditions, the condition of diffuse serous labyrinthitis is also produced.
2) DIFFUSE SUPPURATIVE LABYRINTHITIS
This often leads to purulent discharge from the ear due to the condition of labyrinthitis and due to this destruction of the soft tissue structure of the ear and due to this permanent hearing loss.
3) CIRCUMSCRIBED LABYRINTHITIS
It also involves bony capsule labyrinthitis.
That is, bone also gets involved and fistula formation takes place in the inner ear.
It is called circumscribed labyrinthitis.
clinical manifestation
very dizzy,
Drainage from the ear.
ear pain,
nausea 😵
And vomiting 🤢
Sensorineural hearing loss occurs.
aural fullness,
🤒 fever,
facial weakness 😫,
neck pain,
Ringing in the ears,
Difficulty focusing by eye.
Upper respiratory tract infection also has symptoms.
There are also problems in memory and thinking power,
Depression and anxiety come.
loss of balance.
Diagnostic evaluation
history tacking and physical examination,
a complete physical and nervous system examination should be done,
Electro encephalogram (EEG)
Electroencephalogram,
Electronystagmography
Electronystegmography,
Head ct scan,
hearing test (audiology/audiometry),
mri,
Warning or cooling the inner ear with air or water to test eye reflux.
treatment
Labyrinthitis resolves within a few weeks.
Treatment is done to remove the symptoms.
Medication included
antihistamine,
Medication used to treat nausea and vomiting,
Medication to Relieving Dizziness such as meclizine, or scopolamine,
sedative hypnotonics such as valium.
Nursing assessment
To see if the patient has involuntary eye movements.
Check if the patient feels dizzy or not.
To see if the patient has hearing loss.
Checking the patient’s skin turgor.
Assess the patient’s hydration status.
To see if the patient hears tinnitus or not.
Nursing diagnosis
1) Acute or severe headache related to disease condition.
2) Anxiety related to disease condition.
3) Knowledge deficiency related to disease condition and its treatment and side effect.
4) Impaired social interaction related to communication barriers.
5) Risk for injury related to loss of balance.
Nursing management
Early diagnosis of libertine thytis.
A CT scan of the head is done to check for any injuries.
Perform a neurological examination.
To check that the main cause of the disease is said.
Refer the patient to a speech therapist if he has hearing loss.
Clean the ear with normal saline and antibiotic.
Covering the eye with lotion.
Explain all diagnostic tests to the patient and his family members.
Clearing the wax from the ear.
Be careful not to get another infection dear.
Conduct a hearing test of the patient.
If the patient feels dizzy, give proper medicine.
Provide sedative medicine to the patient to rest properly.
Protecting the patient from any further injury and taking care to prevent hearing loss.
Proper draining and clearing of discharges.
Provide emotional support to the patient.
Treat the patient appropriately if he feels dizzy.
If the patient has a viral infection, give him proper bed rest and maintain his hydration status.
Patients should be treated with antiviral medications such as acyclovir,
Administering femciclovir, valacyclovir to reduce viral infections.
If the patient has a bacterial infection, provide antibiotic medicine.
If the patient has severe nausea, vomiting, give him iv fluid to maintain his hydration status.
Provide the patient with corticosteroid medication.
Teach the patient how to coordinate head and eye movements.
Improving the patient’s walking skills and balance.
Rest properly when the patient has any symptoms.
Do not change the patient’s position suddenly.
Tell the patient not to read while having a period.
Avoid exposure to very bright light.
Do not do too heavy activity.
introduction
Meniere’s disease is a disorder of the inner ear.
Which affects the auditory system (hearing system) and the vestibular system (balance).
These include sudden and recurrent episodes of dizziness and tinnitus and progressive hearing loss, predominantly in one ear.
Meniere’s disease is named after French physician Prosper Menieres.
Who said that vertigo is due to inner ear disorder and he said this in 1861.
Etiology/ cause
exact cause is not known,
most common cause dilatation of endolymphatic systems.
Due to head injury.
Due to middle ear infection
Due to syphilis.
Due to allergic conditions. Due to the use of alcohol.
Due to repeated viral infections.
Due to infection of respiratory tract.
Due to smoking.
due to taking tress.
Due to taking certain types of medicine.
genetic,
aspirin,
smoking cigarettes,
drinking alcohol 🍸,
Due to eating too much salt
Due to low immunity.
clinical manifestation
vertigo and tinnitus,
sweating,
nausea and vomiting,
fullness of both ears,
photophobia
headache,
nystegmus.
Diagnostic evaluation
history taking and physical examination,
audiometric test,
MRI of Head.
management
medical management
Meniere’s DCA is not cured but medicine is provided to relieve the symptoms.
antihistamine,
anticholinergic,
steroids,
Diuretic,
Scopalamine is given if the patient has dizziness and vertigo.
sedative/hypnotonics like diazepam,
antiemetics (promethazine, chlorpromazine),
streptomycin Intramuscular,
If the patient is severe
To provide hearing aid in case of hearing loss.
Ask the patient to eat something low in salt that does not cause acumination of fluid.
Tell the patient to stop smoking.
Exercising regularly.
surgical management
1)endolymphatic sac decompression (endolymphatic sac decompression) :=
In this operation, an incision is made behind the ear and the mastoid bone is exposed.
2) Labyrinthectomy
This involves placing an incision behind the ear and exposing its labyrinth, similar to endolymphatic sac decompression.
3) vestibular neurectomy:=
The vestibular nerve is resected and the vertigo is relieved.
4) cryosurgical method
In this method, a cryo probe is placed over the semicircular canal and subnormal temperature is provided so that the labyrinth tissue is destroyed.
nursing management
assessment
Asking the patient where the vertigo and dizziness started.
To assign the extent of hearing loss.
To assess patient’s vital signs.
Assess the nutritional status of the patient.
Assess the patient’s hydration status.
Assess the patient’s weight.
Weber and Rhee test to check the amount of hearing loss.
Observe the patient for other neurological symptoms such as visual changes, changes in mental status, and motor deficits.
To see if the patient has the condition of nausea and vomiting or not.
Nursing diagnosis
1) Risk for injury related to sudden attacks of vertigo.
preventing injury:=
Ascertain whether the patient has any medical or medical conditions.
Ask the patient to take adequate rest.
Ask the patient to lie down in a safe place if any episodes like dizziness and vertigo occur.
Seek medical personnel’s advice when patient walks.
Abstain from activities like driving, working in heavy machinery, climbing stairs for a week.
Do not overmove.
Avoid exposure to very bright light, TV and reading for a while.
2) fluid volume deficit related to vomiting and impaired intake.
3) Altered nutrition less than body *requirement related to nausea and vomiting.
Nursing interventions:=
ensuring adequate food and fluid.
To assess patient’s intec output.
Ask the patient to take small amounts of fluids and small amounts of feeding when he feels better.
Ask to take fresh meat, poultry, vegetables and fruits in the diet.
Avoid processed meat 🍖, canned products, salt 🧂 all these things.
Tell the patient to avoid caffeine, alcohol, tobacco, as well as chocolate, all of which aggravate the symptoms of Meniere’s disease.
Instruct the patient to avoid smoking.
Smoking constricts the blood vessels, reducing the blood supply to the nerve.
Advise the patient to eat low-salt foods and eat only one to two grams of salt a day.
Olives, pickled food, Chips, some 🧀 cheeses such things should be taken in small quantity.
Provide anti emetic medicine to treat patient’s nausea and vomiting.
4) Anxiety related to* sudden onset of symptoms.
5) Self care deficit* related to vertigo.
nursing interventions
minimize anxiety:=
Explain all procedures to the patient.
Involves in the patient’s daily routine activities.
Tell the patient to stop activity when dizziness occurs and to resume moderate activity when dizziness subsides.
Ask the patient to make moments less.
If there is excessive hearing loss, provide hearing aid to the patient.
Asking the patient to take proper medicine.
Ask the patient to exercise adequately.
Ask the patient to walk a little. Provide exercise, speech exercises, and mind diversional therapy to reduce patient stress.
Ask the patient to take safety measures when experiencing vertigo.
introduction
Otosclerosis
“hardening of 👂 Ear” (Otosclerosis := Hardening of Ear)
In otosclerosis there is abnormal spongy bone growth and this includes the stapes bone of the middle ear.
This causes new bone growth and causes the stapes bone to become immobile (i.e. unable to vibrate).
And because of this sound vibrations are not transmitted and this leads to conductive hearing loss.
Otosclerosis affects both ears.
Otosclerosis or “hardening of bone” is caused by abnormal spongy bone formation and includes the stapes bone of the middle ear.
It also causes conductive hearing loss.
classification of* otosclerosis
1) histological otosclerosis, (histological oto*sclerosis)
2) clinical otosclerosis. (Clinical Auto Sclerosis)
A) Stepedial otosclerosis
B) cochlear otosclerosis (cochlear otosclerosis),
C) mixed otosclerosis
1) Histological otosclerosis:=
In histological auto sclerosis no symptoms are observed during the whole life of the person but they are detected when post mortem is done.
2) Clinical otosclerosis:=
A) Steppedial otosclerosis:=
In this autosclerosis there is formation of spongy bone and it also involves the stapes bone of the middle ear, it is called stapedial autosclerosis.
This leads to conductive hearing loss.
B)cochlear otosclerosis:=
This involves the formation of a spongy bone over the cochlear and also involves the membranous labyrinth leading to sensorineural hearing loss.
C) mixed otosclerosis:=
In this mixed, both the stapes bone and the membranous labyrinth have a spongy bone-like formation and due to this hearing loss is called mixed.
Etiology/ cause
Due to metabolic disorders,
Due to immune disorders,
Due to vascular disease,
Due to infection such as measles
trauma,
Due to abnormality of temporal bone.
clinical manifestation
There is difficulty in hearing.
Dizziness and vertigo occur.
Balance is lost.
A sound like tinnitus is heard in the ears.
One cannot listen for a very long time.
Diagnostic evaluation
history taking and physical examination
otoscopic examination,
run test,
weber test,
audiogram,
tympanometery.
management
medical management
fluoride,
calcium or vitamin D,
Analgesic (ibruprofen, mornin, advil, oxycodone, acetaminophen, pydrocodone, acetaminophen),
hearing aid use to treat hearing loss,
surgical management
1) stapedectomy,
2) stapedotomy ( stapedotomy).
1) Stepedectomy: In stapedectomy, the abnormal spongy stapes bone is removed and a prosthesis is placed between the incus bone and the oval window.
2) stapedotomy:=
This is a modern surgery in which a hole is made in the foot plate of the stapes using a micro drill and a pistol-like prosthesis is placed in it.
Nursing management
assessment
Ask the patient about the history of onset and progression of symptoms.
Assessing the amount of hearing loss.
Assessing the amount of conductive hearing loss with the Rainey test.
post operative care
Providing analgesic medicine to the patient according to the amount of pain after the operation.
Provide dymenhydrinate 50 mg every six hours for post-operative trauma and edema creating vertigo.
Providing side rails on both sides of the bed to prevent the patient from falling.
Provide antibiotic medicine to patient to prevent infection after operation.
Tell the patient not to blow his nose as this may allow air and micro-organisms to reach the eustachian tube.
Avoid sneezing as much as possible.
Do not lift any heavy objects unless the surgeon gives permission.
Advise the patient not to wash the hair for two weeks and take care not to get any kind of water in the ear for six (6 weeks) weeks.
Ear packing is to be removed on the sixth day.
Advise the patient to keep a sterile cotton swab in the ear for a week after the packing is removed when leaving the house.
Change the cotton twice a day.
After six weeks, advise the patient to do their daily routine activities in moderation.
Asking the patient to lie on the operation side will allow for proper drainage.
Displacement of the graft can be prevented if the patient is asked to lie on the non-operated side.
Ask the patient if there is pain, headache, vertigo, and any unusual sensation in the ear.
Provide anti-emetic medicine to the patient to prevent nosia.
Providing antibiotic medicine to the patient.
Nursing management
Improving breathing pattern
Ask the patient to take deep breaths.
Ask the patient to do deep breathing and purse leap breathing.
Provide a comfortable position to the patient.
improve communication related to deafness maintain hygiene.
Ask the patient to maintain hygienic condition.
Providing a neat and clean environment to the patient.
Ask the patient to wear neat and clean clothes.
To observe whether there is any type of pressure ulcer in the skin or not.
Involving family members in the client’s care.
improve nutritional status
Assess the nutritional status of the patient.
To provide safe and clean environment to patients.
Serving food to the patient in an attractive manner.
Provide adequate water to the patient.
Maintain patient’s hydration status.
promote physical mobility
Assist the patient with range of motion exercises.
To involve the patient in daily routine activities.
relieve from fear and anxiety
Ask the patient and his family members to describe his feelings.
Provide psychological support to patients.
To clarify all doubts of the patient in simple language.
improve coping*ability
Provide patient reassurance.
To clear all the doubts of the patient.
Provide patient education about the disease condition in a language that all patients and their family members can understand.
Actively listening to the problems of the patient’s family members.
To involve the patient’s family members in the care of the patient.
To provide complete and correct information to the family members of the patient and give proper information about his recovery and progression.
Deafness results in partial or complete hearing loss.
Mild difficulty hearing in hearing impairment
and total loss of hearing occurs.
Hearing impairment also affects communication, social activities, and work activities.
Deafness reduces a person’s quality of life.
Elderly persons mainly suffer from the problem of hearing loss.
Age-related hearing loss affects 30 to 35% of people between the ages of 65 and 75.
As many as 40% are seen in persons over 70 to 75 years of age.
Most of the hearing loss is due to otitis media and it mainly affects young children.
Hearing loss can also be caused by noise, drugs and toxins, and centennial hearing loss is a genetic condition.
qualification of *hearing loss
Severity of hearing impairment is measured based on loudness and is measured in decibel units.
1) mild:= between 25 and 40 dB.
2)moderate:=between 41 to 55 dB.
3) Moderately severe:= between 56 to 70 dB.
4) severe:= between*71 and 90 dB.
5) Profound:=91 dB or greater.
classification
1) conductive hearing loss, (conductive hearing loss),
2) sensorineural hearing loss. (sensory neural hearing loss)
3) Mixed hearing loss. (mixed hearing loss)
1) Conductive hearing loss:=
Conductive hearing loss is an impairment in any of the normal mechanisms that transmit sound waves from the outer ear to the inner ear, such as the outer ear, ear drum and middle ear bones. If any of these mechanisms are impaired, conductive hearing loss occurs.
Etiology
••external ear :=
Have an impacted ceriumen.
otitis externa,
Foreign body in external auditory canal.
Congenital atresia,
A tumor in the ear canal.
•• middle ear:=
Acute otitis media,
serous otitis media,
Collection of fluid in the middle ear,
Perforation in the tympanic membrane,
tympanosclerosis,
Massage of the ossicular,
middle ear tumor,
Temporal bone trauma,
••inner Ear :=
severe auto otosclerosis,
2) sensorineural hearing loss:=
Sensory neuron hearing loss is caused by dysfunction of the inner ear.
Sensory neural hearing impairment is caused by any damage to the cochlea and the vestibulococcal nerve that transmits hearing to the brain.
Abnormalities are caused by
There can be Mild, Moderate and Severe and also Total Deafness.
Etiology
Sensory neural hearing loss can be congenital or acquired.
As the cochlea is not properly developed,
Due to any chromosomal abnormality,
Due to genetic hearing loss,
Due to age, for example, presbycusis,
Due to any benign or malignant tumor,
Due to certain drugs,
Due to childhood infections such as measles, mumps and meningitis,
Due to any congenital infection eg
Toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis,
premature birth,
alcohol syndrome,
Due to mal nutrition during pregnancy,
Due to any loud noise,
Due to Meniere’s disease,
sudden pressure changes from flying, diving and strenuous exercise,
Due to any type of viral infection,
otosclerosis,
Due to physical trauma such as fracture of the temporal bone,
Due to any type of auto immune disease,
due to HIV or AIDS,
chlamydia cause hearing loss of newborn,
Due to exposure to chemicals.
3) mixed hearing loss:=
Some types of hearing impairment include both sensorineural hearing loss and conductive hearing loss.
Both types of hearing loss are called mixed hearing loss.
clinical manifestation
Due to progressive hearing loss in this,
due to dizziness,
Difficulty speaking
Difficulty understanding words of any kind,
Difficulty speaking
To tell someone very slowly clearly and loudly,
have difficulty hearing,
management
1) Removing wax blockage:=
Remove ear wax gradually with a scoop or suction.
2) hearing aid:=
Hearing loss is caused by damage to the inner ear, so it helps to make the sound stronger and easier to hear.
3) cochlear implants:=
A cochlear implant is a great option if you have severe hearing loss.
In a cochlear implant, an electric device is implanted in the cochlea that transmits sound to the inner ear and stimulates the cochlea, allowing the patient to hear.
4) aural rehabilitation:=
Oral rehabilitation is a process in which hearing loss is identified and diagnosed and various types of treatment are provided.
type of aural rehabilitation therapies
auditory training,
speech reading (speech reading), (lip reading)
hearing aid orientation,
listening strategies,
speech reading,
auditory training,
total communication,
manual communication,.
surgical management
1) restore conductive hearing.
myringotomy,
stapedectomy.
2) Assisted hearing in profound Deafness.
cochlear implants,
temporal bone stimulators (semi implantable hearing device),
3) middle ear implants,
4) tumor excision.
communicating with hearing impaired patients.
Speak clearly and communicate in pure and simple language.
Moving closer to the speaker and trying to hear clearly,
keeping the mouth open,
Repeat the message.
prevention
Protecting ears from any work place,
To see how many amounts are heard,
Avoid exposure to any kind of loud noise.
Tumor of the Ear* and auditory nerve ( Tumor of the ear and auditory nerve.)
Introduction
A vestibular schwannoma
(Also known as acoustic neuroma, acoustic neurinoma or acoustic neurilemoma).
Acoustic neuro is a slow growing tumor of the nerve that connects the ear to the brain.
This nerve is the vestibular cochlear nerve.
This nerve is located behind the ear and inside the brain.
In acoustic neuro it is not cancerous but
is a benign tumor.
It means that this tumor does not spread to other parts of the body.
However it can damage several important nerves as it grows.
Etiology
Age := most people develop acoustic neuroma between the age of 30 and 60.
neurofibromatosis
This is a type of inheritance disorder in which both acoustic neuro-romance
Due to exposure to deion.
clinical manifestation
Vertigo means dizziness.
Hearing loss.
Tinnitus means a ringing sound in the ears.
Difficulty understanding speech.
Dizziness,
headache,
loss of balance,
Numbness occurs.
pain,
sleeplessness,
vision problems,
weakness of the face.
Diagnostic evaluation
history taking and physical examination
decrease feelings on one side of the face,
drooping on one side of the face,
unsteady walk,
MRI of brain,
audiology,
est of equilibrium and balance (electronysyagmography),
test of hearing and brainstem function (brainstem auditory evoked response)
management
observation,
microsurgical removal,
radiation therapy,
treatment
Treatment depends on the size of the tumor, its location, the person’s age and overall health.
The person and their health care provider observe the growth of the tumor and provide radiation therapy to prevent its growth or remove the tumor.
Most acoustic neuroma tumors are small and grow slowly.
When the tumor is small, its symptoms are few and it is mainly seen in old patients, so regular MRI scan is necessary.
If left untreated, an acoustic neuro mass can involve the nerves involved in hearing and balance as well as moment.
If there is a very large tumor, it also causes fluid to build up in the brain and the condition of hydrocephalus occurs.
The condition of hydrocephalus is life threatening.
In Acoustic Neuro it is removed if the following none condition:=
1) large tumor,
2) tumor that are causing symptoms,
3) tumor that are growing quickly,
4) tumor that. Are pressing on the brain.
Surgery is required to remove the tumor and to prevent further nerve damage.
Radio therapy is provided to the patient.
Tumors that are difficult to remove through surgery are provided with radiation therapy to slow their growth.
When the acoustic neuroma is removed, it damages the nerve along with hearing loss and weakness on facial muscles and due to this problem in hearing occurs.
The damage is excessive when the tumor is very large.
Nursing assessment
Asking the patient if he experiences any tinnitus sensation.
Asking the amount of headache by pain scale.
Asking if any injuries have occurred.
Asking the patient if he feels tired and restless.
early detection of tumor by:=
C :=CHANGE IN BOWEL AND BLADDER HABIT,
A:=A SORE THAT DOES NOT CURE,
U:=UNUSUAL BLEEDING,
T:=THICKENIN OF*LUMP AND MASS ,
I:=INDIAGETION AND DIFFICULTY IN SWALLOWING,
O:=OBVIOUS CHANGE IN MOLE ,
N:=NAGGING COUGH .
Nursing management
Management depends on the size of the tumor and its location.
Preventing tumor metastasis.
To prepare the patient emotionally before accepting any situation.
To prepare the patient for chemotherapy and radiation therapy.
Taking care to minimize the side effects after chemotherapy and providing treatment for them.
If Alopecia is occurring i.e. hair loss is excessive, then prevent it from sunlight.
Drink enough water to prevent dehydration.
Applying an emollient to the skin to prevent skin integrity.
Provide proper sedative to the patient to get adequate sleep and rest.
Insufflations of u Stachyn tube
The Eustachian tubes are small passages in the head that connect the ears to the back of the nostrils.
Colds and allergies clog these ducts.
Mild to moderate cysts can be treated at home with over-the-counter medications and prescription solutions.
1) Identify the symptoms:= Swelling due to cold, allergy, infection, it blocks the opening of Eustachian tube and does not allow air to pass through resulting in pressure change and sometimes fluid collects in the ear. When this happens the following symptoms occur. is felt.
ear pain,
Ringing and popping sounds are now heard in the ears.
A sound like tinnitus is heard in the ears.
Difficulty hearing clearly.
Dizziness and difficulty maintaining balance.
2) wriggle jaw:=
This is known as a simple technique that attempts to restore airflow.
In this just move the jaw forward then move it back and forth
1) Vasalva Maneuver:=
This maneuver, which tries to force air through the obstructed passageway and restore airflow, should always be performed with this maneuver. and can cause rapid changes in heart rate.
Take a deep breath and hold it. Close your mouth and close your nostrils.
Try to expel the air from your closed nostrils.
If this maneuver is successful, a popping sound will be heard in the ear and the symptoms will be relieved.
2) Executing Toynbee Maneuver:=
Like the Valsalva patch, the Toyon B maneuver aims to open the obstructed Eustachian tube, but instead of changing the air pressure with each breath, it relies on adjusting the swallowing air pressure.
close your nose,
take a sip of water,
swallow it
Repeat this process until you feel your ears pop and back up.
3) Blow the balloon through the nose := This process sounds silly but this process is correct.
Can be effective for equalizing air pressure in the ear. This device is just a simple balloon with a nozzle that fits into the nostril. If you have a nozzle around the house that will open the balloon and fit securely into the nostril, you can make an autovalent balloon at home.
Insert the nozzle into one nostril and pinch the other nostril closed with your finger.
Inflate the balloon using your second nostril until it is about the size of a fist.
Try repeating the process on the nostrils. Repeat until you hear the pop up sound of the flow being released into the Eustachian tube.
4) Pinch your nose and swallow :=
And also called Lowry stake page.
And it’s a little harder than it sounds. Before swallowing you have to increase the air pressure in your body like you’re trying to have a bowel movement while you hold your breath and try to expel the air. Because some people have difficulty swallowing in these circumstances, however, patience and persistence can open up sharper ears with enough practice.
5) Place a heating pad or warm wash cloth in front of your ear. This can ease any pain you may be experiencing and treat the blockage. The gentle heat of the warm compress helps to close the stanchion tube and help break up some of the congestion. It is necessary to put a cloth in between.
6) use nasal decongestant:=
Ear drops may not relieve your congestion because their use is restricted.
Because the ear and nose are connected by tubes
The spray is an effective way to treat obstruction of the Eustachian tube.
Hold the spray bottle through the nostrils toward the back of the throat almost perpendicularly to the face when you use a decongestant.
Surf as when dodging Hard enough to draw liquid to the back of the throat but not so hard that it is swallowed or drawn into the mouth Try the stimulating maneuver after using detergent They may be more effective at this time.
.