NURS 435 Hearing and Balance Disorders Summary

HEARING AND BALANCE DISORDERS- 07/09/2022




Hearing is conducted over 2 pathways: Air and bone
Otoscopic Examination:
 Inspection: otoscope
 Palpation: indirect/ with a pneumatic otoscope

To examine the external auditory canal and tympanic membrane, the otoscope should be held in the examiner RIGHT HAND, IN A PENCIL-HOLD POSITION, with the examiner’s
hand braced AGAINST patient’s face. [prevent going too far from ext. canal]
 Reasons to examined external auditory:
- Discharge
- Inflammation
- Foreign body

 Healthy tympanic membrane: pearly gray positioned obliquely at the base of the canal
 Proper Otoscopic examination of the external auditory canal and tympanic membrane requires that the canal be free of large cerumen
 If difficulty remove gently with warm water [No, if contraindicated]
Disease Definition Etiology/Patho S/S Labs/Diagnoses Nursing Interventions
 Prevalence increases  Deafness
HEARING LOSS with age  Tinnitus -Talk pt in the less impaired ear , using
 50% over the age of 70 “ringing ears” gestures, facial expressions, to help .
Presbycusis [Age related  Inability to hear
hear. Loss] in group
Occurs in men more than  Turning up tv
women vol.
Risk Factors As hearing loss
 Family history of increases person may
experience:
sensorineural
a. Fatigue

, impairment b. Speech
 Congenital deterioration
malformation of the c. Social isolation
cranial structure[ear] d. Indifference
 Low birth weight e. withdrawal
[<1500 g]
 Bacterial meningitis
 Perforation of
tympanic membrane
 Exposure to excessive
noise levels
 Infection
 Medications
 Ototoxicity
 Trauma
 Tumors

2 Types:***
-Conductive
-Sensorineural

CONDUCTIVE HEARRING LOSS SENSORINEURAL HEARRING LOSS
Results from External ear disorder such as: Causes
 Impacted cerumen [Foreign body] o Damage to cranial nerve VIII [ vestibulocochlear nerve]

Middle ear disorder:
 Otitis Media
COMBINED HEARING  Otosclerosis
LOSS ( C +S)
The efficient transmission of sound by air to the inner ear is interrupted




CONDITIONS OF THE MIDDLE EAR
o The middle ear consist of the tympanic membrane ( eardrum) and the three smallest bones of the body : Malleus , incus, stapes
Caused by:
 Injury
 Disease

,  Aging process


Manifestations include: ear pain, pressure, fever , headache, conductive hearing loss and purulent or bloody drainage if perforation of the eardrum occurs
Risk Factors :
Middle Ear disorders:
Recurrent colds and otitis media
Enlarged adenoids
Trauma
Changes in air pressure ( scuva diving, flying)inner.
Disease Definition Etiology/Patho S/S Labs/Diagnoses Nursing Interventions
ACUTE OTITIS MEDIA Acute infection Caused : Vary severity of - If drainage-
Last less than 6 weeks  Streptococcus infection antibiotic
MC Children pneumoniae Otalgia
 Haemophilus Influenza Drainage Surgical:
 Moraxella Catarrhalis Fever - Myringotomy/
Risk Factors Hearing loss Tympanotomy
Age ( younger than 12 months) Tympanic membrane
Chronic upper respirat. erythematous and
Infections often bulgin
Medical Conditions that
predispose to ear infections
Down Syndrome, cystic
fibrosis cleft palate
Chronic exposure to
secondhand cigarette smoke




Disease Definition Etiology/Patho S/S Labs/Diagnoses Nursing Interventions
OTOSCLEROSIS Involve 1 or both ears
Abnormal spongy bone,
around the oval window with
resulting fixation of the stapes