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Disorders of the external ear (INFECTIONS OF THE EXTERNAL EAR (EAR…
Disorders of the external ear
CONGENITAL DEVELOPMENTAL DEFECTS
Risk factors
Genetics
Toxic drugs during pregnancy
Assessments and common findings
It is important for the midwife to do a thorough examination of the new born to identify any congenital abnormalities, and if found, report to the obstetrician who will do necessary referrals.
Should these be missed during the neonatal period, they should be picked up in the baby clinic where hearing screening is done and milestones tracked.
Congenital defects may affect
The
auricle
, where the pinna is absent or is represented by a small piece at the site. Depending on the shape, thus may be referred to as a ''bat'' or a ''lop'' ear, where the top part of the ear is pushed forward.
The external auditory canal
, may be absent
INFECTIONS OF THE EXTERNAL EAR
EAR ABSCESS/FUNCULOSIS
clinical manifestations
severe pain and hearing loss
diagnostic procedures
a swab will be taken for culture and sensitivity
Definition
this is a localised form of infection that usually occurs following the infection of a hair follicle
management
administer antibiotics as pescribed according to the culture result
surgical incision
drainage
health education
patient should maintain personal hygiene by washing his/her ear and clean the meatus thoroughly
patient must complete the course of prescribed antibiotics and follow instructions
OTITIS EXTERNA
clinical manifestations
serous drainage from the ear
redness and itching
pain, tenderness or a pulling feeling on the pinna
swelling of the skin lining of the ear
nursing management
administer otic antibiotics as pescribed to clear the infection
the ear canal should kept clean and dry by wicking
warm compresses can be applied to reduce pain
causes
the trauma may br caused by pricking the ear with a sharp object e.g. match stick which cauises break in the skin
water may be trapped during swimming and may change the flora of the external canal to produce infection
EAR ABSCESS/FUNCULOSIS
the warm, dark environment of the ear cal provides good medium for the growth of mocro-organisms.
health education
the patient must be informed not to insect any objects into the ear unless he/she is supervised by a healthcare provider
wicking should be done after instruction
definition
infection of the skin covering the outer ear canal that leads into the eardrum
PERICHONDRITIS
clinical manifestations
pain and swelling
an abscess may form
management
application of soothing heat
in cases of an abscess, an incision and drainage will be done and wound care
administering broad-spectrum antibiotics
definition
this is the infection and inflammation of the covering of the cartilage of the pinna, perichondrium.
IIMPACTED CERUMEN
Causes
Cerumen is most likely to become impacted when it is pushed against the eardrum by cotton-tipped applicators,e.g.hair pins, or other objects that people put in their ears.
overproduction of earwax by the glands in the ear canal
abnormally narrow ear canal that tends to trap the wax.
Read more:
http://www.healthofchildren.com/C/Cerumen-Impaction.html#ixzz5m8G7Un1e
Management
wax that is on the tympanic membrane must only be removed by the physician or proffesional nurse
Impacted earwax should be removed by the healcare provoder after spoftening by instilling pescribed eardrops
Definition
accumulated cerumen forming a solid mass that adheres to the wall of the external auditory canal.
health education
Patient should not try to clean the ears with cotton wool buds, as this may impact the wax further
EXTERNAL EAR TRAUMA
management
Ear trauma can be avoided by wearing headgear or earmuffs during contact sports and scuffs or hats during winter to protect them from cold
emphasising on ear hygiene
the pinna is prine to lacerations. during trauma a heamatoma can quickly develop between the skin and cartilage
FOREIGN BODIES IN THE EXTERNAL EAR CANAL
causes
insects cann also become trapped in the external ear canal
children sometimes insert small objects into the ear canal e.g peanuts, beans, buttons
management
insects may be trapped by using sweet oil to prevent them from trying to either fly or crawl further into the external ear
the oil also facilitates easy remocal
refer these patients to hospital for expert management