Tinnitus, Labyrinthitis, and Meniere's Disease

A review of the ANP of the Ear

The ear is broken up into 3 parts:

patholoougytlines.com

Tinnitus: Ringing in the ears.

2 types: Subjective- perceived sounds in the ear by the

patient.

Objective-actual noise made by vascvular tissue near the ear and can sometimes be heard by the doctor.

Causes of Tinnitus

• Trauma to the ear• Obstruction of the ear • Infection• Over doses of salicylates • Tumors • Arteriovenous malformations

Signs and symptoms

• Ascultation of the neck for a buzzing sound.• Pt complaining of any of the following sounds:– Ringing– Buzzing– Roaring– Hissing

Treatment

• Treating the underling disease may lessen tinnitus

• Correct hearing loss• Tinnitus masker(worn like a hearing aid)• Background noise on when going to sleep

What does this mean in the pre-hospital setting?

• Tinnitus can be an indicator for other more serious disease processes

• It can be distracting to the patient and can make communicating with them more difficult if it is severe.

Interesting information on tinnitus

• Nearly every person will experience tinnitus in their lifetime.

• Tinnitus is becoming increasingly more common in young adults due to MP3 players and loud concerts.

• Chronic Tinnitus can cause depression and social anxiety

Labrynthitis: an inflammation of the inner ear canals.

• http://www.med.umn.edu

Causes of Labrynthitis

• Upper respiratory infection• Cold• Flu• Chicken pox• mumps• Middle ear infections• Bacterial infections

Signs and symptoms

• Vertigo• Dizziness• Lightheaded• Tinnitus• Possibly nausea and vomiting

Treatment

Usually labrynthitis goes away on its own. But antibiotics can be prescribed.

It is common to treat the nausea and dizziness with anti-emetic drugs.

What does this mean in the pre-hospital setting?

• Treat the nausea and vomiting• Be cautious with a patient who is dizzy or has

vertigo may not be good to let them walk too much.

• Not a lot EMS can do for Labrynthitis in the pre-hospital setting.

Meniere’s Disease:an inner ear disease

Causes of Meinere’s disease

Meineres disease has no known cause.Some speculate that it is an abnormality in the

fluid of the inner ear.An unhealthy lifestyle can be a contributing

factor in this disease.

Signs and symptoms of Meinere’s:

• Dizziness• Vertigo attacks that can last several days• Tinnitus• Hearing loss• Feeling like your ear is full on the effected side

Treatment:

• Changes in diet, sleep habits and lifestyle• Medications:– Diuretics– Anti-vertigo medications(Anti-vert or Valium)– Anti-emetics

• In extreme cases surgery (labrynthectomy)

What does this mean in the pre-hospital setting?

• Treat the nausea/ and vomiting• Be aware of dizziness and vertigo• They may be experiencing hearing loss and

this may make communicating more difficult•

Interesting information:

• Can cause irritability and insomnia• It can effect your attention span• It has been known to cause anxiety and

depression.• Exercise and a more healthy lifestyle can

improve the signs and symptoms of this disease.

• In extreme cases people have been unable to work or perform daily tasks.

Sources:

1. www.entnet.org2. www.mayoclinic.com3. www.hear-it.org3. Merck Manual eighteenth edition, 20064. Paramedic Care, Bledsoe Porter and Cherry,

2006