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Tinnitus, Labyrinthitis,
and Meniere's Disease
A review of the ANP of the Ear
The ear is broken up into 3 parts:
Tinnitus: Ringing in the ears.
2 types:
Subjective- perceived sounds in the ear by the
Objective-actual noise made by vascvular tissue
near the ear and can sometimes be heard by
the doctor.
Causes of Tinnitus
Trauma to the ear
Obstruction of the ear
Over doses of salicylates
Arteriovenous malformations
Signs and symptoms
• Ascultation of the neck for a buzzing sound.
• Pt complaining of any of the following sounds:
– Ringing
– Buzzing
– Roaring
– Hissing
• Treating the underling disease may lessen
• Correct hearing loss
• Tinnitus masker(worn like a hearing aid)
• Background noise on when going to sleep
What does this mean in the prehospital 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.
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
Labrynthitis: an inflammation of the
inner ear canals.
Causes of Labrynthitis
Upper respiratory infection
Chicken pox
Middle ear infections
Bacterial infections
Signs and symptoms
Possibly nausea and vomiting
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.
What does this mean in the prehospital 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
• Not a lot EMS can do for Labrynthitis in the
pre-hospital setting.
Meniere’s Disease:
an inner ear disease
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.
Signs and symptoms of Meinere’s:
Vertigo attacks that can last several days
Hearing loss
Feeling like your ear is full on the effected side
• Changes in diet, sleep habits and lifestyle
• Medications:
– Diuretics
– Anti-vertigo medications(Anti-vert or Valium)
– Anti-emetics
• In extreme cases surgery (labrynthectomy)
What does this mean in the prehospital 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
Interesting information:
• Can cause irritability and insomnia
• It can effect your attention span
• It has been known to cause anxiety and
• Exercise and a more healthy lifestyle can
improve the signs and symptoms of this
• In extreme cases people have been unable to
work or perform daily tasks.
Merck Manual eighteenth edition, 2006
Paramedic Care, Bledsoe Porter and Cherry,