Practical 1 Dry mopping of ear (equipment: matches and cotton wool)



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Practical 1 Dry  mopping of ear

(equipment: matches and cotton wool)

 

Indications



 Otitis externa and media

 

What you need



Cotton wool and wooden stick

 

How to do it



 Wrap cotton wool around stick and twist.

Make the end fluffy

When placing the fluffy end into the ear canal ensure some of the cotton wool is under your finger to ensure the cotton wool is not lost

Change the cotton wool a few times

Check the ear canal afterwards with otoscope

 

Possible complications



 Very unlikely

Scratch to ear canal if to rough

Cotton wool may come off if not held properly 
Practical 2 Removal of foreign body with syringing

(equipment: 20 ml syringe, brown venflon)

 

Indications



 Inorganic foreign body

 

What you need



 20 ml syringe

Brown venflon (metal needle removed)

Bowel to collect saline

Warm saline or water (37o C)

 

How to do it



 Hold pinna back and up to straighten ear canal

Flush ear canal initially gently aiming at the posterior superior of canal.

Once foreign body removed check no other foreign bodies and state of tympanic membrane (also check other side)

 

Possible complications



 Otitis externa: treat with antibiotic ear drops.

Perforation of tympanic membrane: treat conservatively as most will heal spontaneously, keep ears dry.

 
Practical 3 Ear syringing

(equipment: 20 ml syringe, brown venflon)

 

Indications



 Hearing loss due to wax (generally rare).

 

What you need



 Automated syringing machine

 

Or



 

20ml/50 ml syringe

Brown venflon with metal needle removed

Warm saline or water (37o C)

 

How to do it



 Soften wax with Sodium Bicarbonate ear drops (3 drops tds for 3 days prior to syringing). Wax is more soluble in water than oil. Olive oil will also help but will not disperse ear wax.

Hold pinna back and up to straighten ear canal

Flush ear canal initially gently aiming at the posterior superior of canal.

Once wax removed check no more wax. If there is more hard wax further softening with  Sodium Bicarbonate ear drop for 3 days and repeat. Check state of tympanic membrane once wax cleared.

 

Possible complications



 

Otitis externa: treat with antibiotic ear drops.

Perforation of tympanic membrane: treat conservatively as most will heal spontaneously, keep ears dry.

 
Practical 4 How to make an ear wick



(equipment: matches, cotton wool)

 

Indications



 Acute otitis externa with a narrow ear canal.

 

What you need



 1.25 cm ribbon gauze or gauze cut to this width.

 

How to do it



 Fold over the gauze so that there are four layers and the wick is 2 cm long.

One end is introduced into the ear canal for 1.5 cm using forceps.

To the external end can now be applied antibiotic ear drops.

 

Possible complications



 

Rarely damage to ear canal.



Practical 5 Hearing Aid

(equipment: a hearing aid, mould and tubing)

 

What are the different part of the hearing aid?



 

Mould


Tubing

Hearing aid body

 

How to switch hearing aid on.



 

 

How to check if hearing aid is working.



 

How to change battery.

 

How to put a hearing aid in.



 
Practical 6 How to hold child for ear exam or syringing

(equipment: an unruly child!)

 

Indications



 

  • If child uncooperative

  • Generally avoid restraint if practical, consider alternatives such as GA.

  • Do a exam on parent to calm child down.

  • Consent from parent.

  • Parent to hold child

Syringing of ear in child

 

What you need



 

Chair


Nurse & parent to help

 
How to do it

 

 

Possible complications



 

None


Practical 7 Ear Anatomy

 

Model of ear



 

Poster of ear

 

Putt the arrow on the right bit!


Attic

 
Handle of malleus

 

Eustachian tube shadow



 

Chorda tympani

 

Long process of incus



 

Light reflex

 

Round window shadow



 

Annulus of tympanic membrane

 

Left ear


 

Right ear


Attic

 

Handle of malleus



 

Eustachian tube shadow

 

Chorda tympani



 

Long process of incus

 

Light reflex



 

Round window shadow

 

Annulus of tympanic membrane



 

Left ear


 

Right ear




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