Conditions of the inner ear (Menieres's disease)

Symptoms

Vertigo

Tinnitus

Hearing loss

Pathophysiology

Postulated that tissue changes in the labyrinth trigger production of excess endolymph. Which distorts the contour of the membranous labyrinth and destroys the delicate vestibular and cochlear hair cells.

Risk factors

Ear infections

Foreign bodies

Tumours like cholesteatoma

Prolonged exposure to noise

Poor ear hygiene

Ototoxine medication (streptomycin)

Trauma to the tympanic membrane

Head injury involving there vestibulocochlear nerve.

Causes

Is unknown, but it is thought to be related to the malabsorption of the endolymph in the membranous labyrinth.

Both ears are affected

The excessive accumulation of endolymph results in the dilatation of the membranous labyrinth which impacts on balance.

It affects mainly adults between the ages of 20 and 60 children as young as four years of age and adults as old as 90 have been reported to suffer from the disease

Nursing care plan

Counseling

Symptomatic care should be implemented

Encourage rest

Sedation antiemetic of medications for motion sickness.

The should be kept in a quiet room and comfortable position

The patient must avoid sudden head movement or changes in position to prevent falling

Administer medications.

Medications

Antihistamines

Benzodiazepines

Anticholinergic

Nursing diagnosis (subjective data)

Aural fullness

Tinnitus

Fluctuating hearing loss

Vertigo

A feeling of being pulled to the ground

Objective data

The patient should be referred for audiometric studies and vestibular test. A physical examination should include a neurological examination, because there is an overlap between manifestations of inner ear conditions and central nervous system disorders.