Otic Disorders
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1
What are the exclusions for self-treatment?
signs of infection
pain w/ ear discharge
bleeding/trauma
ruptured tympanic membrane
ear surgery within last 6 weeks
tympanostomy tubes
incapable of following instructions
hypersensitivity to recommended agents
<12 years old
pain w/ ear discharge
bleeding/trauma
ruptured tympanic membrane
ear surgery within last 6 weeks
tympanostomy tubes
incapable of following instructions
hypersensitivity to recommended agents
<12 years old
2
What is cerumen?
ear wax
3
What is cerumen a mixture of?
secretions from the ear canal & sloughed epithelial cells
4
What is the functions of cerumen?
lubricates canal
traps dust & foreign materials
waterproof barrier
antibacterial properties
traps dust & foreign materials
waterproof barrier
antibacterial properties
5
What are signs of excessive or impacted cerumen?
sensation of ear fullness, dull pain, or itching
can also see tinnitus, dizziness, vertigo, cough, & hearing loss
can also see tinnitus, dizziness, vertigo, cough, & hearing loss
6
What are the risk factors for excessive or impacted cerumen?
hearing aids
earplugs
headphones
cotton swabs
earplugs
headphones
cotton swabs
7
What are the treatment options for impacted cerumen?
cerumenolytic agents w/ or w/o irrigation
manual removal by provider
observation
manual removal by provider
observation
8
What is the cerumen-softening agent?
carbamide peroxide 6.5% in anhydrous glycerin
-the only FDA approved agent
-the only FDA approved agent
9
What age group can use carbamide peroxide 6.5% in anhydrous glycerin?
12 years & older
10
How often should carbamide peroxide 6.5% in anhydrous glycerin?
5-10 drops BID PRN up to 4 days
11
What are examples of water-based cerumen-softening agents?
choline salicylate
potassium carbonate
distilled water
saline
phenazole
urea peroxide
docusate sodium
potassium carbonate
distilled water
saline
phenazole
urea peroxide
docusate sodium
12
What are oil-based cerumen-softening agents?
almond oil
benzocaine
chlorbutanol
triethanolamine polypeptide
benzocaine
chlorbutanol
triethanolamine polypeptide
13
What can be attempted alone or in combo with a cerumenolytic?
irrigation
14
What product should be used for irrigation?
sterile water
15
When should manual removal be performed?
only if earwax has migrated to the outer external ear canal
only for adult use
only for adult use
16
What are the causes of water-clogged ears?
shape of ear canal & excessive cerumen
excessive moisture
cotton tips, headphones, etc
excessive moisture
cotton tips, headphones, etc
17
What can water-clogged ears lead to?
tissue maceration, which can cause itching, pain, inflammation, & infection
18
What is swimmer's ear?
an infection of the external auditory canal
"otitis externa"
"otitis externa"
19
What are non-pharmacological approaches for water-clogged ears?
earplug products: leave in canal 5-10 minutes after swimming to absorb any trapped water then discard
pull gently on ear lobe while tilting head downwards
use blow dryer on lowest setting pointed towards ear canal
pull gently on ear lobe while tilting head downwards
use blow dryer on lowest setting pointed towards ear canal
20
What is the pharmacological treatment for water-clogged ears?
isopropyl alcohol 95% in anhydrous glycerin 5%
-only FDA approved "ear drying agent"
-only FDA approved "ear drying agent"
21
What is a home remedy for water-clogged ears?
50:50 mixture of acetic acid (white vinegar) & isopropyl alcohol 95%
-has bactericidal & antifungal properties
-lowers pH of ear
-has bactericidal & antifungal properties
-lowers pH of ear
22
What should you not use for water-clogged ears?
cider vinegar
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