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xt Book of Medical Surgical Nursing-t J 3, © 8, Non-pharmacologic measures such as application of heat by warm compress and, relaxation technique may help to reduce postoperative ear pain., , '9, Administer medications; antibiotics, analgesics, antiemetics, and antihistamines as, prescribed by the doctor., , 10, Assess hearing acuity by using the whisper voice test, Rinne’s test and weber test, , postoperatively., , Labyrinthitis is an inflammation and infe, e labyrinths that_ house the vestibula r syste, ances of balance and hearing to var :, ark is vertigo (vertigo is a type of dizzines, , , , , of the inner ear. It derives its name from, , linically,. this condition produces distur-,, and may affect one or both ears. The hall, , , Inflamed, labyrinth, , , , Fig. 7: Labyrinthitis, , ETIOLOGY, , _Labyrinthitis usually follows an infection in another part of the body, such as acute, media or meningitis. Labyrinthitis is almost always caused by viral irifection, but can, ely be caused by bacterial infection, head injury, neoplasm of the middle ear or cranial, ve VIII, after middle ear or mastoid surgery, extreme stress, an allergy, drinking large, F lounts of alcohol or as a reaction to a particular medication espécially y aspirin. ae, ; _Labyrinthitis often follows an upper. respiratory tract infection. Infection’ may’ also reach, ! oe ear via the bloodstream from elsewhere in the body. Both bacterial and viral labyrintis can cause permanent hearing loss, although this is rare., PATHORUVeIA! AAV :, , , , , , EM) ae

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TYPES, , , , , , , i, Diffuse Serous Labyrinthitis; It is a type of acute labyrinthitis that somes, |, lows drug intoxication or overindulgence in alcohol. It can also be caused by Allerg,, 2, Diffuse Suppurative Labyrinthitis: y¢ the inflammatory process continues, , ing loss., , date becomes purulent, then the condition is known as diffuse suppurative or Puruley, rinthitis. Destruction of soft tissue structures from the infection can cause Permaneys|, , 3, Circumseribed Labyrinthitis: In this type the bony capsule is eroded and p, nous labyrinth is exposed (fistula formation). Lab, fistula only. ., , yrinthitis is localized to the area gh., CLINICAL MANIFESTATIONS, , Extreme Verti;, , s igo and Dizziness (loss of balance and a sensa, room is spinning) ~~“ ‘- ‘ :, , e tion|that either you af:, Sensorineural hearing loss _, “Aural fullness, , Tinnitus (Ringing in the ears), ® Difficulty focusing the eyes because of involuntary eye movements, Otorrhea SS, eee. . ., Nausea or vomiting, Fever, , , , 2,, “Facial weakness or asymmetry, “Neck pain/stiffness. :, . Upper respiratory tract infection symptoms (p; . ., “ Cognitive symptoms such as memory /thinking nis 8 or concurrent), * Depression and anxiety_. a, DIAGNOSTIC EVALUATION, 1. A thorough medical history, including 5, , tions, is essential to diagnosing labyrinthi P, hearing loss., , toy, tis ag yp, , .

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Rtv ces Surgical Nursing-I, , , , Studies: No specific laboratory studies are avail, 8 ae cerebrospinal fluid if meningitis is suggested. If ei y, Ppa CBC count and blood cultures are indicated. si gir infection is con, gered, 4 ees rm eo, ei esting of middle ear effusions if present, and select appre ten ree, ' lerapy, ii ;, , able’ for labyrinthitis,, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , rdingly- ., ot logic Examination: Perform an external inspection for signs of mastoiditis, cell, , jitis, OF prior ear surgery. Inspect the ear canal for otitis externa, otorrhea, or sect,, inspect the tympanic membrane and middle ear for the presenc ‘, , : e of i, cholesteatoma, middle ear effusion, or acute otitis media. Vai com, , tion: Inspect the ocular range of i i, , Ocular Examina’ : ae ge of motion and pupillary res ’, , 4 perform funduscopic examination to assess for papilledema. Ceedrieiioe aelage, mus (spontaneous, gaze-evoked, and positional). Warming and cooling the inner ear, with water (caloric stimulation) to test eye reflexes, , Neurologic Examination: Perform a complete cranial nerve examination. Assess for, , balance using the Romberg test and tandem gait: Assess cerebellar function by per, forming finger-to-nose and heel-to-shin tests. a, , 6, Imaging Studies: A CT scan is also useful to help rule out mastoiditis as a potential, cause. MRI can be used to help rule out acoustic neuroma, stroke, brain abscess, or, epidural hematoma as potential causes of vertigo and hearing loss., , 1. Audiography: Persons with viral labyrinthitis have mild-to-moderate high-frequency, SNHL in the affected ear, although any frequency spectrum may be affected., , 4, Vestibular Testing: Persons. with viral, labyrinthitis have nystagmus with unilateral, caloric vestibular paresis /hypofunction. : ‘, , , , , ne, , | OF, , ANAGEMENT, , |. Vertigo can be treated with medications such as meclizine or scopalamine. Medica, tions are only used short-term for balance trouble. They ‘allow the brain to learn to, , adjust to the inner ear injury. Special exercises can often help speed and improve the, , brain's ability to adjust., , Free treatment of viral labyrinthitis consists of bed rest and hydration. The ants—, val drugs acyclovir, famciclovir, and valacyclovir shorten the duration of viral shed, din, y, Tor b may prevent some auditory and vestibular damage., culture ial labyrinthitis, broad-spectrum antibiotic treatment is selected based _on, § Pate and sensitivity results. ~~~ Mee a, coca ausea iti i i nous fluid an, antien th Severe nausea and vomiting may benefit from ane 7 Se alae, , _ Vesti © Medications, Benzodiazepines (Diazepam oF Lorazepam), % rs Suppressant. , ee a =, , . ‘Os| s . l=, : Tinthit; ee reduce labyrinthine inflammation and prevent the = aan, - elect, o infectious or inflammatory causes. Intratympanic sarod a aie, areal) ee systemic steroids in the treatment of sudden hearing ‘09°, , we bular Reh, ee with systemic steroids. or nay substantially, or gp eulitation Therapy: VRT isa highly effective way °° exercises can, , ulnate residual dizziness from labyrinthitis. Rehabilitation, , a

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Nursing Management of eter, , exercises are included:, Help ‘desensitise’ your body to the symptoms, , Learn how to coordinate your eye and head movements, Improve your balance and walking skills’, , , , VU Oe e Yn ive f i, 5 muh, , “speedup: the brain’s natural ability to adjust to problems with balance. Folloyt