Pediatric ProblemsOtitis MediaForeign bodies -beads, pencil erasers, insectsTreatment -carefully remove foreign body (if able) -seek medical care

Ménière's Disease• Ménière's Disease: entire inner ear canal

system affected • Population at risk:

- usually first occurs in people aged 20 – 50 yrs old-more common in men and in white people

• S & S: three main features -Tinnitus - one-sided sensorineural hearing loss - vertigo

Treatment for Ménière's DiseaseNonsurgical management includes: -slow head movements

-diet and lifestyle changes -smoking cessation.

Drug Therapy• Nicotinic Acid

• Antihistamines: -diphenhydramine hydrochloride (Benadryl)

• Antiemetics: -chlorpromazine hydrochloride (Thorazine)

• Intratympanic therapy: gentamicin & steroids

• Other Measures: Meniett device

Meniett’s DeviceTreatment with Meniett’s device -tympanostomy tube inserted into eardrum -pulses of pressure delivered to inner ear

-self directed for 5 mins. TID -studies shown effective in reducing vertigo *

*Gates,G., Verrall,A., Green,J.D., Tucci, D.L., & Telian, S.A.(2006). Meniett clinical trial:Long –term follow-up. Archives of Otolaryngology-Head and Neck Surgery, 132(12), 1311-1316.

Ménière’s Disease: Surgical ManagementEndolymphatic decompression.

Surgical management: last resort because hearing in the affected ear is often lost

from the procedure

Labyrinthectomy

Hearing LossTypes of hearing loss

Conductive r/t inflammation or obstruction of external or middle ear

Sensorineural r/t loud noise, drugs, medical problem

Population at risk: older adult

Anatomy of Hearing Loss

Treatment for Hearing LossNon-surgical

-hearing aids -assistive devices using amplifiers

Surgical Interventions -tympanoplasty -stapedectomy

Tympanoplasty

Nursing Interventions: Pre-opFree of infectionEar flushesPt. Education: post op expectations

-hearing diminished initially -medications

Nursing Interventions Post-opMonitor dressingsAvoid increased pressure on earMedicationsPositioning -Tympanoplasty: lie flat with operative ear

face upPotential complication for stapedectomy -Assess for facial nerve damage or muscle

weakness

Community-Based CareHome care management

Health teaching

Health care resources

Worldwide

http://www.wfdeaf.org/

NURSING DIAGNOSES FOR ALTERED HEARING

Risk for injury related to altered auditory perception

Social Isolation related to decreased hearing

Anxiety related to loss of hearing