DEAFNESS AND ITS
MANAGEMENT
INTRODUCTION
•Deafness: Complete loss of hearing ability
in one or both ears.
•Hearing Impairment: Loss of hearing ability
ranging from mild to profound.
DEGREES
•Slight: 16–25 dB
•Mild: 26–40 dB
•Moderate: 41–54 dB
•Moderately Severe: 55–70 dB
•Severe: 71–90 dB
•Profound: 91 dB or greater
•Totally Deaf (Anacusis): No hearing
TYPES
• Conductive Hearing Loss: Occurs when sound waves
cannot efficiently travel through the outer or middle
ear.
• Sensorineural Hearing Loss: Results from damage to
the inner ear or auditory nerve pathways.
• Mixed Hearing Loss: A combination of conductive and
sensorineural hearing loss
ETIOLOGY /RISK FACTORS
•Conductive Causes:
•Otitis media (middle ear infection)
•Cerumen impaction (earwax buildup)
•Otosclerosis (abnormal bone growth in the middle ear)
• Sensorineural Causes:
• Presbycusis (age-related hearing loss)
• Noise-induced hearing loss
• Meniere’s disease
• Head trauma
• Genetic factors
• Systemic conditions like diabetes and
hypertension .
SYMPTOMS
• Difficulty understanding speech
• Frequently asking others to repeat themselves
• Listening to media at higher volumes
• Tinnitus (ringing in the ears)
• Strained facial expressions or tilting head when listening
• Diplacusis (perception of different pitches in each ear)
Diagnostic methods
• Otoscopic Examination: Visual inspection of the ear
canal and tympanic membrane.
• Rinne’s and Weber’s Tests: Tuning fork tests to
differentiate between conductive and sensorineural
hearing loss.
• Audiometry: Quantitative assessment of hearing
thresholds across various frequencies
MANAGEMENT
•Pharmacological Treatment:
•Antibiotics for infections
•Corticosteroids for inflammation
•Antiviral medications for viral infections
SURGICAL MANAGEMENT
• Myringotomy (incision of the eardrum to relieve
pressure)
• Stapedectomy (removal of the stapes bone in cases
of otosclerosis)
• Cochlear implantation for profound sensorineural
hearing loss.
ASSISTIVE DEVICES
• Hearing Aids: Amplify sound for individuals with mild
to moderate hearing loss.
• Cochlear Implants: Electronic devices that stimulate
the auditory nerve directly, suitable for severe to
profound sensorineural hearing loss.
• Assistive Listening Devices: FM systems, amplified
telephones, and alerting devices.
Rehabilitation and Support
• Speech and Language Therapy: Helps individuals improve
communication skills.
• Aural Rehabilitation: Training to maximize residual hearing
and adapt to hearing loss.
• Sign Language: Alternative communication method for those
with profound hearing loss.
• Psychosocial Support: Counseling to address emotional and
social challenges associated with hearing loss.
Epistaxis (Nosebleed)
Classification of Epistaxis
• Anterior Epistaxis
• Posterior Epistaxis
ETIOLOGY
• Local Causes: trauma, nose-picking, infections, tumors
• Systemic Causes: hypertension, bleeding disorders,
anticoagulant use
• Environmental Factors: dry air, high altitude
SIGNS AND SYMPTOMS
• Bleeding from one or both nostrils
• Blood in throat or mouth
• Feeling of nasal obstruction
DIagnosis
• History taking
• Physical examination (anterior rhinoscopy)
• Laboratory tests: CBC, clotting profile
• Nasal endoscopy (for posterior bleeds)
MANAGEMENT
•First Aid / Initial Care:
•Sit upright, pinch nostrils, cold compress
•Medical Management:
•Nasal packing (anterior/posterior)
•Cauterization[Uses heat or chemicals to burn and
destroy tissues]
•Nasal decongestants
•Surgical Intervention:
•Ligation of arteries (e.g., sphenopalatine artery)
NURSING MANAGEMENT
• Monitoring vital signs
• Positioning and comfort
• Administering medications
• Assisting with nasal packing or cauterization
• Patient education on prevention
