Cholesteatoma

Definition
Cholesteatoma

is a type of skin CYST located in the middle ear. noncancerous tumor

Causes
Cholesteatomas are most often caused by: Ear infections Congenital defects Poorly functioning eustachian tube

Symptoms

Discharge from the ear, sometimes foulsmelling 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
nerve damage to the ear
Caloric X-ray

stimulation- a test which diagnoses

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

Treatment
Cleaning Thorough cleaning of the ear is necessary to remove fluid and bacteria. Eardrops are also usually administered. Surgery Surgery may be necessary if the tumor is threatening hearing or balance. Medications Medications 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

Improving hearing and communication

Check V/S (temp.) CBC (WBC count) Administer antibiotics Inform pt. to avoid swimming Use aseptic techniques after surgery

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