Treatments for Ear conditions
Hospital statistics for Ear conditions:
These medical statistics relate to hospitals, hospitalization and Ear conditions:
- 148,937 admissions to private hospitals because of ear and mastoid process diseases in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
- 257,538 patient days spent in private hospitals for ear and mastoid process diseases in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
- 29,596 admissions to public hospitals because of ear and mastoid process diseases in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
- 29.2% of hospitalisations for ear and mastoid process diseases in private hospitals are single day in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
- more hospital information...»
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Hearing Loss:
Treatment
(In a Page: Signs and Symptoms)
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In many cases, the physical exam is therapeutic, because it involves cleaning the ear canal
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For middle ear effusions, a course of antibiotics and observation is usually sufficient; if symptoms persist, myringotomy and tube placement may be indicated
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Hearing aids are helpful for most cases of conductive or sensorineural hearing loss
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Middle ear implantable devices for moderate to severe sensorineural hearing loss
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Cochlear implants may be indicated for severe to profound sensorineural hearing loss if hearing aids are of minimal or no benefit
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Reconstructive middle ear surgery may be necessary, and includes tympanoplasty and stapedectomy
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Prevention of additional hearing loss by ear protection
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Otorrhea:
Treatment
(In a Page: Signs and Symptoms)
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Otitis externa is treated with antibiotic drops; alternatively, acidification of the ear canal with acetic acid is also effective; patients should follow water precautions and abstain from the use of cotton swabs
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Otomycosis of the ear canal is also treated with topical antifungal preparations as well as acidification
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Otitis media with tympanic membrane perforation should be treated with systemic antibiotics; precautions should be taken with topical antibiotics because many are known to be ototoxic (only ofloxacin is approved for usage in the middle ear)
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Foreign bodies in the ear can be removed with alligator forceps under direct visualization, or the patient can be referred to an otolaryngologist emergently
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Patients with cholesteatoma, mastoiditis, and cerebrospinal fluid leak should be emergently referred to an otolaryngologist
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Ear Pain:
Treatment
(In a Page: Signs and Symptoms)
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If patient is in distress, immediately stabilize airway, breathing, and circulation
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Pain control with acetaminophen, NSAIDs, warm compress, and topical benzocaine solution
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Otitis media: Most patients with risk factors (e.g., persistent fever, immunocompromise) should be treated with appropriate antibiotics
–Serous otitis media that persists for >3 months may require a course of corticosteroids or myringotomy
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Otitis externa: 8% aluminum acetate ±2% acetic acid (especially eczematous otitis externa), antibiotics, steroid drops
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Malignant otitis externa: IV antipseudomonal or antistaphylococcal antibiotics
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Cerumen and foreign bodies: Remove with a curette
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Pharyngitis/tonsillitis: Appropriate antibiotics
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Barotrauma: Pinch nose, then exhale with mouth closed to equalize pressure; decongestants
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TMJ: NSAIDs, physical therapy, dental bite adjustment
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Otorrhea (Ear Discharge):
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Suction and debride the external auditory canal
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Maintain dry ear precautions
–No water at all allowed within ear canals
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Ototopical antibiotics
–Unless TM is intact, use nonototoxic (e.g., fluoroquinolone) drops
–Antifungal solution for candidal infections
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Steroid drops
–Often a combination product with antibiotic drops
–Essential if granulation tissue is present
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Reacidification of canal
–Acetic acid drops
–Treats both fungal and bacterial infections
–Painful if TM is not intact
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Oral antibiotic
–For refractory cases of middle ear etiology
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Prolonged IV antibiotics for severe refractory cases
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Otalgia (Ear Pain):
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Establish appropriate specific diagnosis as promptly as possible
- If infectious process, initiate antimicrobial therapy
–Topical (intraotic) antibiotic drops for otitis externa or otitis media with either a perforation or patent tympanostomy tube
–Systemic (oral) for otitis media, nonviral pharyngitis, sinusitis
–Parenteral antibiotics for abscess, mastoiditis
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If odontogenic, dental referral
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Adequate follow-up to ensure resolution of otalgia
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hearing Loss – Acquired:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Cerumen removal
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Tympanostomy tube placement for chronic MEE lasting >3 months if bilateral, >6 months if unilateral
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Tympanoplasty for TM perforation
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Tympanomastoidectomy for cholesteatoma
–Effort to keep external auditory canal wall intact, with second look procedure planned for 6 months later
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Ossicular chain reconstruction (OCR, ossiculoplasty) with prosthesis or incus graft for ossicular anomalies
–Including after cholesteatoma resection
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Exploratory tympanotomy for suspected PLF
–If present, seal off oval and round windows
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Resection of CPA tumor
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Steroids for autoimmune SNHL (systemic or intratympanic)
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Cochlear implants for profound pre- or postlingual deafness
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Habilitation of any post-treatment hearing loss
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hearing Loss – Congenital:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Identify children with hearing loss early
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Treat medically treatable cause, if any
–Syphilis (steroids and penicillin), Lyme disease, toxoplasmosis, hypercholesterolemia
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Intravenous gancyclovir for congenital CMV
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Habilitate by age 6 months if possible
–Amplification
–Bone-anchored hearing aids
–Tympanostomy tube placement
–Middle ear reconstruction
–Perilymphatic fistula closure
–Cochlear implant (after age 12 months)
-
Periodic follow-up necessary
–Ensure auditory habilitation is working
–Check for hearing loss progression
>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hearing loss:
Treatment
(Professional Guide to Diseases (Eighth Edition))
After the underlying cause is identified, therapy for congenital hearing loss refractory to surgery consists of developing the patient’s ability to communicate through sign language, speech reading, or other effective means. Measures to prevent congenital hearing loss include aggressively immunizing children against rubella to reduce the risk of maternal exposure during pregnancy; educating pregnant women about the dangers of exposure to drugs, chemicals, or infection; and careful monitoring during labor and delivery to prevent fetal anoxia.
Treatment for sudden deafness requires prompt identification of the underlying cause. Prevention necessitates educating patients and health care professionals about the many causes of sudden deafness and the ways to recognize and treat them.
Hyperbilirubinemia can be controlled by phototherapy and exchange transfusions. Children need the appropriate immunizations. Medications that may be ototoxic should be used judiciously in children and monitored closely. Reduction of exposure to loud noises generally prevents high-frequency hearing loss.
In people with noise-induced hearing loss, overnight rest usually restores normal hearing in those who have been exposed to noise levels greater than 90 dB for several hours; but not in those who have been exposed to such noise repeatedly. As hearing deteriorates, treatment must include speech and hearing rehabilitation, because hearing aids are seldom helpful. Prevention of noise-induced hearing loss requires public recognition of the dangers of noise exposure and insistence on the use, as mandated by law, of protective devices such as earplugs during occupational exposure to noise.
Amplifying sound, as with a hearing aid, helps some patients with presbycusis, but many patients have an intolerance to loud noise and wouldn’t be helped by a hearing aid.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Benign tumors of the ear canal:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Generally, a benign tumor requires surgical excision if it obstructs the ear canal, is cosmetically undesirable, or becomes malignant.
Treatment for keloids may include surgery followed by repeated injections of long-acting steroids into the suture line. Excision must be complete, but even this may not prevent recurrence.
Surgical excision of an osteoma consists of elevating the skin from the surface of the bony growth and shaving the osteoma with a mechanical burr or drill.
Before surgery, a sebaceous cyst requires preliminary treatment with antibiotics, to reduce inflammation. To prevent recurrence, excision must be complete, including the sac or capsule of the cyst.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hearing loss:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to avoid exposure to loud noise and to use ear protection to arrest hearing loss. If the patient has an upper respiratory tract infection, tell him to avoid flying and driving.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Otorrhea:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Advise the patient with chronic ear problems to avoid forceful nose blowing when he has an upper respiratory infection so that infected secretions are not channeled into the middle ear. Instruct him to blow his nose with his mouth open. Also, remind him to cleanse his ears with a washcloth only, and not to stick anything in his ear (such as a hairpin or a cotton-tipped applicator) that might cause injury. If the patient is a swimmer, instruct him to wear earplugs and to wash and dry his ears thoroughly after swimming. Have him report recurring ear pain and drainage, especially in the absence of upper respiratory infection, as this may be a sign of cancer.
Tell the patient with a ruptured tympanic membrane that such a rupture usually heals spontaneously. However, warn him to avoid immersing his head in water while it heals; tell him to insert lubricated cotton balls into his ear canal before he showers or shampoos.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Hearing loss:
Treatment
(Handbook of Diseases)
Measures for treating each type of hearing loss vary.
Congenital hearing loss
After identifying the underlying cause, therapy for congenital hearing loss refractory to surgery consists of developing the patient’s ability to communicate through sign language, speech reading, or other effective means.
Measures to prevent congenital hearing loss include aggressively immunizing children against rubella to reduce the risk of maternal exposure during pregnancy; educating pregnant women about the dangers of exposure to drugs, chemicals, or infection; and careful monitoring of the fetus during labor and delivery to prevent fetal anoxia.
Sudden hearing loss
Treatment of sudden hearing loss requires prompt identification of the underlying cause. Prevention requires educating patients and health care professionals about the many causes of sudden hearing loss and the ways to recognize and treat them.
Noise-induced hearing loss
Overnight rest usually restores normal hearing in those who have been exposed to noise levels greater than 90 dB for several hours but not in those who have been exposed to such noise repeatedly. As hearing deteriorates, treatment must include speech and hearing rehabilitation because hearing aids are seldom helpful.
Prevention of noise-induced hearing loss requires public recognition of the dangers of noise exposure and insistence on the use, as mandated by law, of protective devices, such as earplugs, during occupational exposure to noise.
Presbycusis
Patients with presbycusis usually require a hearing aid.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Earache:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient or his parents how to instill eardrops if they’re prescribed for home use. Encourage the patient to complete the full course of antibiotics if prescribed. If the patient experiences vertigo, tell him to rise slowly from a sitting or lying position. Warn the patient not to insert anything into the ear to avoid trauma, infection, and ear pain.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hearing loss:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to avoid exposure to loud noise and to use ear protection to arrest loss. If the patient has an upper respiratory tract infection, tell him to avoid flying and driving. Explain the importance of completing the full course of prescribed antibiotics.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Otorrhea:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Advise the patient with chronic ear problems to avoid forceful nose blowing when he has an upper respiratory infection so that infected secretions aren’t channeled into the middle ear. Instruct him to blow his nose with his mouth open. Also, remind him to clean his ears with a washcloth only, and not to stick anything in his ear that might cause injury (such as a hairpin or a cotton-tipped applicator). If the patient is a swimmer, instruct him to wear earplugs and to wash and dry his ears thoroughly after swimming. Have him report recurring ear pain and drainage, especially in the absence of upper respiratory infection, because this may be a sign of cancer.
Tell the patient with a ruptured tympanic membrane that such a rupture usually heals spontaneously. However, warn him to avoid immersing his head in water while it heals; tell him to insert lubricated cotton balls into his ear canal before he showers or shampoos.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hearing loss:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ When talking with the patient, remember to face him and speak slowly.
▪ Don't shout, smoke, eat, or chew gum when talking.
▪ Prepare the patient for audiometry and auditory evoked-response testing.
▪ Provide an alternate means of communication, if necessary.
Patient teaching
▪ Explain interventions to the patient, such as a hearing aid or cochlear implant to improve his hearing.
▪ Discuss the importance of ear protection and avoidance of loud noise.
▪ Stress the importance of following instructions for taking prescribed antibiotics.
▪ Explain the underlying cause of the hearing loss and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Otorrhea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Apply warm, moist compresses, heating pads, or hot water bottles to the patient's ears to relieve inflammation and pain.
▪ Use cotton wicks to gently clean the draining ear or to apply topical drugs.
▪ Keep eardrops at room temperature because instillation of cold eardrops may cause vertigo.
▪ If the patient has impaired hearing, ensure that he understands everything that's explained to him, using written messages if necessary.
Patient teaching
▪ Instruct the patient on safe ways to blow his nose and clean his ears.
▪ Stress the use of earplugs when swimming.
▪ Explain signs and symptoms that require medical attention.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Earache [Otalgia]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Administer an analgesic.
▪ Apply heat to relieve discomfort.
▪ Instill eardrops if necessary.
Patient teaching
▪ Teach the patient or the parents how to instill drops if they're prescribed for home use.
▪ Explain the importance of taking prescribed antibiotics correctly.
▪ Explain ways to avoid vertigo.
▪ Instruct the patient and family about ways to avoid ear trauma.
▪ Explain the cause of the earache once a diagnosis has been established.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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