Disease of EAR,NOSE,THROAT & management

ByMr. ASHOK BISHNOI

Lecturer JINR

Anatomy & Physiology:-

Otology:- The study of disease of the ear.

Otalgia:- Pain in the ear due tom disease of jaw joint, neck, throat or teeth.

Tinnitus:- The sensation of sound in the ear.

Vertigo:- Swimming of the head .

Otorrhea:- Any discharge from the ear.

Otorrhagia:- Bleeding from the ear.

TERMINOLOGY:-

Otomycosis:- A fungus infection of the ear causing irritation & inflammation.

Deafness:- Loss of hearing.

Otoplasty :-Surgical Repair & Reconstruction of the ear.

Otorhinolaryngology:- Study of ear, nose & throat disease.

Audiometry:- An apparatus for measuring hearing.

Tympanoplasty:- It is repairment of tympanic membrane.

Myringotomy:- Incision in tympanic membrane.The fluid is section out

of middle ear,cavity.

Osteitis:- Inflammation in bone.

Mastoiditis:- Inflammation of the mastoid antrum and cell.

Mastoiditis:-

Otitis media

Osteosclerosis

Menieres disease

Perichondritis

Permanent sensorineural hearing loss

EAR DISORDER:-

Definition:-

“It is an inflammation of middle ear that most often occur in infant & young children but can occur at any age”

OTITIS MEDIA:-

Most common in children under 15 yr of age.

Incidence:-

1. Acute otitis media2. Chronic otitis media

Other-

a. Serous otitis mediab. Secretory otitis mediac. Suppurative otitis media

Classification:-

Definition-

“It is an acute infection of the middle ear, usually lasting less then 6 weeks”

1.ACUTE OTITIS MEDIA:-

Bacteria eg. Streptococcus pneumoniae, H. Influenza

Upper respiratory tract infection

Infection nasopharynx

Etiology:-

Due to etiological factor(URTI, Bacteria)

Exudates & edema in middle ear

Decrease retraction of tympanic membrane

Serous exudates in middle ear

Pus formation

Tympanic membrane rupture

ACUTE OTITIS MEDIA

Pathophysiology:-

Otorrhea Otalgia Fever Rhinitis Tympanic membrane erythema, may be perforated

Hearing loss Irritability

Clinical Manifestations:-

History

Physical examination

Otoscopic examination

Culture

Audiometry & Tympanometry

Diagnostic evaluation:-

Medical Management-

Antibiotic Analgesic Antihistamine

Surgical management-

Myringotomy or tympanotomy (incision in the tympanic membrane)

Management

Chronic otitis media

Hearing loss

Perforation

Poor speech develop

Complication:-

Perforation:-

Definition:- “It is a long standing infection of a part of whole of the middle year characterised by ear discharge & permanent perforation”

OR“Inflammation of the middle ear that lasts for more than 6 weeks”

2.CHRONIC OTITIS MEDIA:-

Common in the age 3-6

Incidence:-

Inappropriate treatment of acute otitis media.

URTI, Allergic rhinitis.

Breastfeeding and long time group child care

Eustachian tube deformity

Septal deviation, cleft palate, sinusitis

Etilogy:-

Classification:-

Chronic otitis media

Suppurative +(perforation)

atico-antral type

Tubo-tympanic type

Non suppurative

Mucoid or serous

a.Atico-antral chronic otitis media –

Inflammation involves bones (e.g. mastoid, tympanic ring, ossicles ).

b.Tubo-tympanic otitis media-

Acute otitis media permanent perforation muco-purulent discharge.

1.Suppurative(+ perforation)

a.Serous Otitis media-

Stages: URTI or acute otitis media–> Fluid collection in

middle ear and obstruction of eutachian tube tympanic membrane retraction.

Fluid become pus like necrosis tympanic membrane perforation.

Could end up with mastoiditis ( if not stopped ).

2.Non suppurative-

hearing loss Otorrhea Tinnitus

Clinical Manifestations:-

Medical management- careful suctioning of the ear under

microscopic guidance. Instillation of antibiotic drops

Surgical management- Tympanoplasty Ossiculoplasty (surgical reconstruction of the middle ear

bones to restore hearing)

Mastoidectomy

Management:-

Assessment:- Collect health history includes a complete

description of the ear problem. Collect data about the duration and intensity of

the problem, its causes, and previous treatments. Obtain Information about other health problems

and medications. Physical assessment includes observation for

erythema, edema, otorrhea, lesions, and characteristics such as odor and color of discharge.

Nursing management:-

Pain R/T Infection Risk for infection R/T eustachian tube dysfunction.

Altered auditory sensory perception R/T Fluid in the middle year.

Anxiety R/T surgical procedure, potential loss of hearing,

Risk for trauma R/T balance difficulties or vertigo during the immediate postoperative period.

Nursing diagnosis:-

Disturbed sensory perception R/T potential damage to facial nerve (cranial nerve VII).

knowledge deficient R/T disease, surgical procedure,and postoperative care.

THANK YOU