Comprehensive Guide: Assessment &
Management of Ear Disorders
1. Ear Assessment & Diagnostic Tests
Inspection of the External Ear
● Check for deformities, lesions, discharge, size, symmetry, and attachment angle.
● Pain on auricle manipulation → Suspect acute external otitis.
● Mastoid tenderness → Possible mastoiditis.
Otoscopic Examination
● Used to inspect the tympanic membrane (color, position, and integrity).
Gross Auditory Acuity Tests
● Whisper Test – Assesses ability to repeat whispered words.
● Weber Test – A tuning fork placed on the forehead:
○ Heard louder in affected ear → Conductive hearing loss.
○ Heard louder in better ear → Sensorineural hearing loss.
● Rinne Test – Air conduction vs. bone conduction:
○ If bone conduction is longer → Conductive hearing loss.
○ If air conduction is longer → Sensorineural hearing loss.
Audiometry
● Pure-tone audiometry: Determines softest sound a person can hear.
● Speech audiometry: Tests ability to understand spoken words.
Tympanometry
● Measures middle ear function by checking tympanic membrane response to sound.
Electronystagmography (ENG)
● Evaluates the vestibular system, used for Ménière’s disease and acoustic neuroma
diagnosis.
Auditory Brainstem Response (ABR)
● Detects nerve conduction issues from the ear to the brain.
2. Hearing Loss & Nursing Management
Conductive Hearing Loss
Definition: Conductive hearing loss occurs when sound waves cannot pass through the outer
and middle ear properly due to obstruction or damage.
Causes:
● Impacted cerumen, otitis media, perforated eardrum, otosclerosis
Nursing Management:
● Assist with hearing aids (ensure proper fit and function).
● Encourage ear hygiene (avoid cotton swabs, excessive earwax buildup).
● Provide clear communication strategies (speak slowly, face patient).
● Monitor for signs of infection (pain, drainage, redness).
Sensorineural Hearing Loss
Definition: Sensorineural hearing loss occurs due to damage to the inner ear (cochlea) or
auditory nerve, affecting sound perception and clarity.
Causes:
● Aging (presbycusis), noise exposure, ototoxic drugs, Ménière’s disease
Nursing Management:
● Educate about noise protection (earplugs, avoiding loud environments).
● Monitor for ototoxic medication use (e.g., aminoglycosides, loop diuretics).
● Assist with hearing devices (cochlear implants if needed).
● Encourage nonverbal communication (writing, sign language).
Mixed Hearing Loss
Definition: Mixed hearing loss is a combination of conductive and sensorineural hearing loss,
affecting both sound transmission and processing.
Nursing Management:
● Implement interventions for both conductive and sensorineural loss.
● Encourage regular audiology follow-ups.
● Teach proper hearing aid use if prescribed.
3. Common Ear Disorders & Treatments
Cerumen Impaction
Definition: Cerumen impaction occurs when excessive earwax builds up in the ear canal,
leading to blockage and hearing loss.
Symptoms: Fullness, pain, hearing loss. Management: Irrigation, suction, manual removal.
Nursing Management:
● Educate on safe ear cleaning (no cotton swabs).
● Use prescribed softening drops (mineral oil, glycerin).
● Monitor for ear pain or infection post-irrigation.
Otitis Externa ("Swimmer’s Ear")
Definition: Otitis externa is an infection or inflammation of the external ear canal, often caused
by bacteria or fungi.
Symptoms: Pain, discharge, itching, redness. Treatment: Antibiotics, corticosteroid drops, pain
relief.
Nursing Management:
● Instruct patient to avoid inserting objects into the ear.
● Teach to keep ears dry during showers/swimming.
● Apply prescribed ear drops correctly.
● Monitor for fever or worsening pain (indicates infection).
Acute Otitis Media (AOM)
Definition: Acute otitis media is an infection of the middle ear, often following an upper
respiratory infection.
Symptoms: Ear pain, fever, purulent drainage. Complications: Hearing loss, mastoiditis,
meningitis.
Nursing Management:
● Administer prescribed antibiotics (Amoxicillin).
● Encourage fluids and rest.
● Apply warm compress for pain relief.
● Educate on completing antibiotics fully.
● Monitor for ear drainage (indicates rupture).
Surgical Management: Myringotomy (Tympanotomy)
● Incision in eardrum to drain fluid and relieve pressure.
Post-Op Nursing Care:
● Keep ear dry for 2 weeks.
● Avoid blowing nose forcefully.
● Monitor for excessive drainage.
(Additional conditions follow the same structure, defining each hearing disorder before
discussing causes, symptoms, and nursing management.)
This document provides a detailed nursing management plan for each hearing disorder
and surgical procedure, now including clear definitions for each condition. Let me know if
you need any refinements!
