DISORDERS OF THE EAR

DISORDERS OF THE EAR

Risk Factors Related To Ear Disorders

 aging process
 infection
 medications
 ototoxicity
 trauma
 tumors

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CONDUCTIVE HEARING LOSS

Description  occurs when sound waves are blocked to the inner ear fibers because of external or middle ear
disorders
 disorders often can be corrected with no damage to hearing or minimal permanent hearing loss
Causes  any inflammatory process or obstruction of the external or middle ear
 tumors
 otosclerosis
 a buildup of scar tissue on the ossicles from previous middle ear surgery

SENSORINEURAL HEARING LOSS

Description  pathological process of the inner ear or the sensory fibers that lead to the cerebral cortex
 often permanent
 measures must be taken to reduce further damage or to attempt to amplify sound as a means of
improving hearing to some degree
Causes  damage to the inner ear structures
 damage to VIIIth cranial nerve
 prolonged exposure to loud noise
 medications
 trauma
 inherited disorders
 metablic and circulatory disorers
 infections
 surgery
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 Meniere’s syndrome
 diabetes mellitus
 myxedema

MIXED HEARING LOSS

Description  also known as conductive-sensorineural hearing loss
 pt has sensorineural and conductive hearing loss

COCHLEAR IMPLANTATION
Description  used for sensorineural hearing loss
 small computer converts sound waves into electrical impulses
 electrodes are placed by the internal ear with a computer device attached to the external ear
 electronic impulses directly stimulate nerve fibers

HEARING AIDS
Description  used for pt with conductive hearing loss
 can help pt with sensorineural hearing loss – but not as effective
 amplification of background noise and voices – can be problematic
Patient  encourage pt to begin usin gthe hearing aid slowly to adjust to the device
Education  adjust the volume to minimal hearing level to prevent feedback squeaking
 teach pt to concentrate on the sounds that are to be heard and to filter out background noise
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 instruct pt to clean ear mold with mild soap and water
 avoid excessive wetting of the hearing aid and try to keep hearing aid dry
 clean ear cannula of the hearing aid with a toothpick or pipe cleaner
 turn off the hearing aid and remove the battery when not in use
 keep extra batteries on hand
 keep hearing aid in a safe place
 prevent hair sprays, oils, or other hair and face products from coming into contact with the receiver of
the hearing aid

PRESBYCUSIS 
Description  presbycusis – a sensorineural hearing loss associated with aging
 leads to degeneration or atrophy of the ganglion cells in the cochlea and a loss of elasticity of the
basilar membranes
 leads to compromise of the vascular supply to the inner ear, with changes in several areas of the ear
structure
Assessment  hearing loss is gradual and bilateral
 pt states that he or she has no problem with hearing but cannot understand what the words are
 pt thinks that the speaker is mumbling

EXTERNAL OTITIS
Description  an infective inflammatory or allergic response involving the structure of the external auditory canal or
auricles
 an irritating or infective agent comes into contact with the epithelial layer of the external ear
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 contact leads to an allergic response or signs and symptoms of infection
 skin becomes red, swollen, and tender to touch on movement
 the extensive swelling of the canal can lead to conductive hearing loss because of obstruction
 more common in children
 termed swimmer’s ear
 occurs more often in hot, humid environments
 prevention – includes elimination of irritating or infectious agents
Assessment  pain
 itching
 plugged feeling in ear
 redness and edema
 exudate
 hearing loss
Inteventions  apply heat locally for 20 min 3 x a day
 encourage rest to assist in reducing pain
 administer antibiotics or corticosteroids a/o
 administer analgesics such as aspirin or acetaminophen for pain a/o
 instruct pt to keep ears clean and dry
 instruct pt to use earplugs for swimming
 instruct pt that cotton-tipped applicators should not be used in dry ears because their use can lead to
trauma to the canal
 instruct the pt that irritating agents such as hair products or headphones should be discontinued

OTITIS MEDIA
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Table 59-3 Clinical Features of Otitis

Feature Acute Otitis Externa Acute Otitis Media

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