INNER EAR INFECTION, MEDICAL SURGICAL NURSING

1. OTOSCLEROSIS
SUDESHNA BANERJEE DUTTA; SENIOR LECTURER

2. OTOSCLEROSIS
❖ Otosclerosis or “hardening of the ear” result from
the formation of an abnormal bone growth along
the stapes in the middle ear
❖ With the new bone growth , the stapes become
immobile prevents transmission as sound
vibration into the ear, leading to conductive
hearing loss
❖ Otosclerosis usually affect the both ears

4. CLASSIFICATION
There are mainly two types of classification:-
➢ Histological otosclerosis
➢ Clinical otosclerosis

5. CLASSIFICATION
Histological otosclerosis:- This type of
otosclerosis does not produce any
symptoms during life but is revealed only at
postmortem
Clinical otosclerosis There are three sub types
✓ Stapedial otosclerosis
✓ Cochlear otosclerosis
✓ Mixed otosclerosis

6. CLASSIFICATION
❖ Stapedial otosclerosis:- The otosclerosis focus
may produce ankylosis of the membraneous
labyrinth
❖ Cochlear otosclerosis:- The otosclerotic process
proceeds upon the membraneous labyrinth
producing sensory-neural deafness
❖ Mixed otosclerosis:- Otosclerosis causes both
fixation of the stapes as well as in involvement of
the labyrinth so that is mixed hearing loss

9. CAUSES
❑ Exact cause is not known
❑ Heredity: Family history of deafness is present
in 50% of cases
❑ Viral infection(Measles etc.)
❑ Other ear conditions

10. CLINICAL
MANIFESTATIONS
➢ Hearing loss(progressive deafness which is
painless and is insidious)
➢ Dizziness
➢ Tinnitus
➢ Buzzing in the ear
➢ Vertigo
➢ Headache & otalgia

11. DIAGNOSTIC EVALUATION
❖ History
❖ Physical examination
❖ Tuning fork test
❖ Audiometry test
❖ Tympanocentesis –send the fluid of middle ear for
culture
❖ CT scan – collection of fluid in ear & mastoid
region , abscess formation
❖ MRI – evaluation of tumor & soft tissue
❖ Audiography – to assess hearing capability

12. MANAGEMENT
❑ Otosclerosis may slowly get worse. The
condition may not require treatment until one
having severe hearing problems
❑ Administer analgesics such as –
• IBUPROFEN
• OXYCODONE
• ACETAMENOPHEN (PCM)
❑ Hearing aid may be used to treat the hearing
loss

13. SURGICAL MANAGEMENT
➢ Stapedectomy:- The removal of portion of the
sclerotic stepes footplate of stapes or complete
removal of the stapes and the implant with
prosthesis to maintain suitable conduction.
➢ Stapedotomy:- Modern surgery called
stapedotomy is performed by drilling a small hole
in the stapes footplate with micro drill or laser,
and the insertion of a piston like prosthesis

15. COMPLICATIONS
➢ Complete deafness
➢ Infection
➢ Dizziness
➢ Pain
➢ Blood clot in the ear after surgery

16. SELF CARE AT HOME (POST-
OPERATIVE)
➢ Take medicine as prescribed
➢ Blow nose gently
➢ Sneeze and cough with mouth open for few weeks after surgery
➢ Avoid heavy lifting, straining and bending
➢ Popping and crackling sensation are normal for 3-5 weeks after
surgery
➢ Temporary hearing loss is normal in operative ear
➢ Change cotton ball in the ear as needed
➢ Avoid getting in water for 2 weeks after surgery