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Cholesteatoma
Definition Cholesteatoma is a type of skin CYST
located in the middle ear. noncancerous tumor
CausesCholesteatomas are most often caused by: Ear infectionsCongenital defectsPoorly functioning eustachian tube
Symptoms Discharge from the ear, sometimes foul-
smelling Pressure in the ear Hearing loss Earache Numbness of the ear Dizziness Muscle weakness in the face on the affected
side
Diagnose Hearing tests Balance tests CT scan Electronystagmography- used to test the
function of the nerves related to hearing Caloric stimulation- a test which diagnoses
nerve damage to the ear X-ray
Complications Deafness in one ear Dizziness (vertigo) Erosion into the facial nerve (causing
facial paralysis) Labyrinthitis Meningitis Persistent ear drainage Spread of the cyst into the brain
TreatmentCleaningThorough cleaning of the ear is necessary to remove fluid and bacteria. Eardrops are also usually administered.SurgerySurgery may be necessary if the tumor is threatening hearing or balance.MedicationsMedications are necessary to dry up the fluid in the ear and include ear drops and oral antibiotics. Antibiotics are prescribed to eliminate any infection in the ear.
Nursing Care Assessment
The health history includes a complete description of the ear disorder, including infection, S&S, previous ear treatments, hereditary information
Physical - Presence of erythema, edema, lesions and characteristics such as odor and color of discharge.
Nursing Diagnoses Anxiety related to surgical procedure Acute pain related to infection/ear
disorder/surgery Risk of infection related to
abscess/surgery Disturbed auditory sensory perception
related to ear disorder/surgery/packing (post-op)
Risk for trauma related to impaired balance or vertigo during the immediate post-op
Nursing interventions Reducing Anxiety
Inform and educate pt. about his current condition and the treatments
Allow pt. to ask questions Reliving Pain
Use pain score ruler to assess the pain position pt. lateral, (effected ear below) Serve medication to relive pain Give Diversional therapy
Preventing Infection Check V/S (temp.) CBC (WBC count) Administer antibiotics Inform pt. to avoid swimming Use aseptic techniques after surgery
Improving hearing and communication Assess pt. hearing Reduce environmental noise, facing pt. when
speaking, speak clearly (post-op) Use other methods of communication
Preventing injury CRIB Assist in ambulation Inform pt. to avoid heavy lifting, straining,
exertion and nose blowing for 2-3 weeks post-op
Give antivertiginous meds (antihistamines) Promoting Home care
Instruction about medication Cleanliness of ear