Ear Disorders

Tracie Kirkland, DNP, RN, ANP-BC,

CPNP

 Ear Disorders

•  Normal anatomy/
physiology
•  Structure
•  Func6on

h7p://www.cdc.gov/getsmart/community/images/ear-infec6on-lg.jpg
What is the function of the inner ear?
What is the function of the
Eustachian tube?
 Ear Disorders

O66s O66s Media/

O66s Media
Externa Effusion
Swimmer’s ear
Involves pinna or TM
Occurs secondary to
Acute infec6on involving the middle
retained moisture ear MEE with s/s of acute ear infec6on
Edema, discharge, and erythema
Furuncles or abscesses
Impe6go

S/S ear pain, irritability, otorrhea,

Caused by pseudomonas aeruginosa and/or fever Intermi7ent pain with fullness in ear
Staphylococcus aureus Bulging TM Popping sensa6on, fullness
Streptococcus pyogenes Limited mobiiity Dizziness/impaired balance
Candida Air/fluid buildup behind TM
Ear Disorders

h7ps://upload.wikimedia.org/
wikipedia/commons/thumb/c/c9/
O66s_
externa.jpg/1280px-
O66s_externa.jpg
 Otitis Media with Effusion
•  Clinical manifesta6ons
•  OYen asymptoma6c/afebrile
•  Mild ear pain
•  Fullness, i.e., popping or altered sounds
•  Dizziness or impaired balance

•  Treatment
•  Watchful wai6ng
•  Hearing test (audiometry) **billable item correlated
to ICD-10
•  Early iden6fica6on for children at risk for hearing, speech,
and language
 Myth or Fact?
•  Students are to u6lize an updated journal to answer the
following myth or fact.
•  Iden6fy whether the statement is a myth or fact.
•  Provide appropriate evidence to support response.
•  Provide a one- to two-sentence response.

•  Decongestants aren’t recommended for treatment of OM

with effusion.
•  Tonsillectomy or adenoidectomy should be used as
treatment for OME.
•  Ear g7s. may not be associated with 8th cranial nerve
damage.
 Otitis Externa
•  Clinical manifesta6ons
•  Pruri6s/irrita6on
•  Pressure/fullness with occasional hearing loss
•  Otorrhea
•  Periauricular edema
•  Pre-/postauricular lymphadenopathy

•  Treatment
•  O6c g7s containing ace6c acid or an6bio6c with and or without
cor6costeroids
•  I.e., cor6sporin g7s. administer 3–4x/day x5–7 days
•  ** o6c g7s should not be used if TM is not intact
•  Pa6ent educa6on on expecta6ons, i.e., use of g7s, ear wicks,
posi6oning of pa6ent during ins6lla6on of g7s.
 Otitis Media
•  Clinical manifesta6ons
•  Ear pain with pulling, tugging
•  Otorrhea
•  Fever
•  Conges6on, i.e., stuffy nose, rhinorrhea, and sneezing

•  Risk factors
•  Prematurity
•  Exposure to secondhand smoke

•  Treatment
•  Reference chart slide
•  Pa6ent educa6on
•  Referral
 Do You Know
•  What are the most common infec6ng organisms in
AOM?
•  What is the first line of treatment?
•  What addi6onal recommended treatment is suggested
in the event a child has been on an6bio6cs within 30
days of ini6a6ng tx? Why?
•  What would you expect to find on physical
examina6on?
•  What is an example of a type I hypersensi6vity
reac6on?
 Discover and Learn
•  U6lize images from the previous slides.
•  Iden6fy the type of ear disorder.
•  Describe clinical manifesta6ons of each disorder.
•  What is the appropriate treatment regimen? (U6lize
guidelines to determine evidence-based treatment.)
•  What pa6ent educa6on would you provide to a parent of
a 2-year-old presen6ng with o66s media?
•  Does pa6ent educa6on differ for an 8-year-old? If so, why
or why not?
•  What is the recommenda6on for referral?
Recommended Treatment

h7p://
www2.gov.bc.ca/
assets/gov/health/
prac66oner-pro/
bc-
guidelines/
images/
o66s_1.png