1. Tinnitus, Labyrinthitis, and Meniere's Disease

2. A review of the ANP of the Ear
The ear is broken up into 3 parts:
patholoougytlines.com

3. Tinnitus: Ringing in the ears.
2 types: Subjective- perceived sounds in the ear by the patient. Objective-actual noise made by vascvular tissue near the ear and can sometimes be heard by the doctor.

4. Causes of Tinnitus Trauma to the ear Obstruction of the ear Infection
Over doses of salicylates
Tumors
Arteriovenous malformations

5. Signs and symptoms Ascultation of the neck for a buzzing sound.
Pt complaining of any of the following sounds:
Ringing
Buzzing
Roaring
Hissing

6. Treatment Treating the underling disease may lessen tinnitus
Correct hearing loss
Tinnitus masker(worn like a hearing aid)
Background noise on when going to sleep

7. What does this mean in the pre-hospital setting?
Tinnitus can be an indicator for other more serious disease processes
It can be distracting to the patient and can make communicating with them more difficult if it is severe.

8. Interesting information on tinnitus
Nearly every person will experience tinnitus in their lifetime.
Tinnitus is becoming increasingly more common in young adults due to MP3 players and loud concerts.
Chronic Tinnitus can cause depression and social anxiety

9. Labrynthitis: an inflammation of the inner ear canals.

10. Causes of Labrynthitis
Upper respiratory infection
Cold
Flu
Chicken pox
mumps
Middle ear infections
Bacterial infections

11. Signs and symptoms Vertigo Dizziness Lightheaded Tinnitus
Possibly nausea and vomiting

12. Treatment
Usually labrynthitis goes away on its own. But antibiotics can be prescribed. It is common to treat the nausea and dizziness with anti-emetic drugs.

13. What does this mean in the pre-hospital setting?
Treat the nausea and vomiting
Be cautious with a patient who is dizzy or has vertigo may not be good to let them walk too much.
Not a lot EMS can do for Labrynthitis in the pre-hospital setting.

14. Meniere’s Disease: an inner ear disease

15. Causes of Meinere’s disease
Meineres disease has no known cause. Some speculate that it is an abnormality in the fluid of the inner ear. An unhealthy lifestyle can be a contributing factor in this disease.

16. Signs and symptoms of Meinere’s:
Dizziness
Vertigo attacks that can last several days
Tinnitus
Hearing loss
Feeling like your ear is full on the effected side

17. Treatment: Changes in diet, sleep habits and lifestyle Medications:
Diuretics
Anti-vertigo medications(Anti-vert or Valium)
Anti-emetics
In extreme cases surgery (labrynthectomy)

18. What does this mean in the pre-hospital setting?
Treat the nausea/ and vomiting
Be aware of dizziness and vertigo
They may be experiencing hearing loss and this may make communicating more difficult

19. Interesting information:
Can cause irritability and insomnia
It can effect your attention span
It has been known to cause anxiety and depression.
Exercise and a more healthy lifestyle can improve the signs and symptoms of this disease.
In extreme cases people have been unable to work or perform daily tasks.

21. Sources: www.entnet.org www.mayoclinic.com www.hear-it.org
3. Merck Manual eighteenth edition, 2006
Paramedic Care, Bledsoe Porter and Cherry, 2006