Common ear disorders are cerumen (ear wax) impaction, otitis external, oti-
tis media (infections of the external and middle ear), and vestibular disorders of
the inner ear.CERUMEN IMPACTION
Cerumen (ear wax) is produced by glands in the outer portion of the ear canal.
Cerumen moves down the canal to the external os (opening) where the cerumen
is washed away. When this process fails, cerumen becomes impacted and must
be loosened by using ceruminolytics such as a hydrogen peroxide solution (3%
diluted to^1 / 2 strength with water). The ear canal is irrigated with ceruminolytics,
which flushes cerumen deposits out of the ear canal. Patients who have chronic
cerumen impaction are treated with drops of olive oil or mineral oil or by
Cerumenex and Debrox. Cerumenex is available by prescription and Debrox is
an over-the-counter medication.OTITIS EXTERNA AND OTITIS MEDIA
Otitis externa and otitis media are infections of the external and middle ear,
respectively. These disorders are treated with analgesics and antibiotics.
Antibiotics are discussed in Chapter 13. Analgesics are discussed in Chapter 16.
Table 22-2 contains commonly used antibiotics for ear infections. Most ear
infections are caused by a virus and should not be treated with an antibiotic.VESTIBULAR DISORDERS
The most frequently reported symptoms of vestibular disorders are dizzi-
ness, unsteadiness or imbalance when walking, vertigo, and nausea. These
symptoms may be quite mild, lasting minutes, or quite severe, resulting in
total disability.
Because the vestibular system interacts with many other parts of the ner-
vous system, symptoms may also be experienced as problems with vision,
muscles, thinking, and memory. In addition, people with vestibular disorders
may suffer headache and muscular aches in the neck and back, increased ten-
dency to suffer from motion sickness, and increased sensitivity to noise and(^406) CHAPTER 22 Disorders of the Eye and Ear