Cholesteatoma

Definition Cholesteatoma is a type of skin CYST

located in the middle ear. noncancerous tumor

CausesCholesteatomas are most often caused by: Ear infectionsCongenital defectsPoorly functioning eustachian tube

Symptoms Discharge from the ear, sometimes foul-

smelling Pressure in the ear Hearing loss Earache Numbness of the ear Dizziness Muscle weakness in the face on the affected

side

Diagnose Hearing tests Balance tests CT scan Electronystagmography- used to test the

function of the nerves related to hearing Caloric stimulation- a test which diagnoses

nerve damage to the ear X-ray

Complications Deafness in one ear Dizziness (vertigo) Erosion into the facial nerve (causing

facial paralysis) Labyrinthitis Meningitis Persistent ear drainage Spread of the cyst into the brain

TreatmentCleaningThorough cleaning of the ear is necessary to remove fluid and bacteria. Eardrops are also usually administered.SurgerySurgery may be necessary if the tumor is threatening hearing or balance.MedicationsMedications are necessary to dry up the fluid in the ear and include ear drops and oral antibiotics. Antibiotics are prescribed to eliminate any infection in the ear.

Nursing Care Assessment

The health history includes a complete description of the ear disorder, including infection, S&S, previous ear treatments, hereditary information

Physical - Presence of erythema, edema, lesions and characteristics such as odor and color of discharge.

Nursing Diagnoses Anxiety related to surgical procedure Acute pain related to infection/ear

disorder/surgery Risk of infection related to

abscess/surgery Disturbed auditory sensory perception

related to ear disorder/surgery/packing (post-op)

Risk for trauma related to impaired balance or vertigo during the immediate post-op

Nursing interventions Reducing Anxiety

Inform and educate pt. about his current condition and the treatments

Allow pt. to ask questions Reliving Pain

Use pain score ruler to assess the pain position pt. lateral, (effected ear below) Serve medication to relive pain Give Diversional therapy

Preventing Infection Check V/S (temp.) CBC (WBC count) Administer antibiotics Inform pt. to avoid swimming Use aseptic techniques after surgery

Improving hearing and communication Assess pt. hearing Reduce environmental noise, facing pt. when

speaking, speak clearly (post-op) Use other methods of communication

Preventing injury CRIB Assist in ambulation Inform pt. to avoid heavy lifting, straining,

exertion and nose blowing for 2-3 weeks post-op

Give antivertiginous meds (antihistamines) Promoting Home care

Instruction about medication Cleanliness of ear