learning Objectives - Describe disorders and diseases of ear, nose and throat. Demonstrate skills in Providing nursing care for patients with various ENT problems.
Hours - 15
Teaching and Learning Activities - Lecture cum discussion Clinical teaching Demonstration Videos, charts
Assessment Methods - Short answer Objective type Essay Return demonstration
Content of the chapter
Ear
a) Review of Anatomy and physiology of Ear
b) Assessment of function of ear
– History
– Ear examination
– Diagnostic tests
c) Diseases and disorders of the ear
External ear
– Otitis
– Foreign body
– Impacted cerement
– Furunculosis
Middle ear
– Otitis media
– Mastoiditis
– Perforation of ear drum
Internal ear
– Presycusis
– Labryinthitis
– Meniere’s disease
– Otosclerosis
Deafness
– Conductive deafness
– Neural deafness
Tumors of the ear and auditory nerve
Insufflations of Eustachian tube
Nose
a) Review of Anatomy and physiology of nose
b) Assessment of functions of nose
– History
– Examination of nose
– Diagnostic tests
c) Diseases and disorders of nose
Infections
– Rhinitis
– Sinusitis
– Obstruction
– Polyps
Foreign body
Deviated nasal septum
Trauma – fracture of nasal bone and
epitaxies
Throat
a) Review of Anatomy and physiology of Throa
b) Assessment of the function of throat
– History
– Examination of throat
– Diagnostic tests
c) Diseases and disorders of throat infections
and inflammation
– Tonsillitis
– Pharyngitis
– Adenoiditis
– Laryngitis
– Tumors
– Injury and foreign body
– Alternate therapies
– Drugs used in treatment of ENT disorders
Nursing Management of Patients with Disorders and Diseases of Ear, Nose, and Throat
ENT nursing focuses on assessment, prevention, early detection, treatment, and rehabilitation of ear, nose, and throat disorders. Nurses play a critical role in supporting patients, assisting in diagnostic and surgical procedures, administering medications, and health education.
EAR
a) Review of Anatomy and Physiology of Ear
- External ear: auricle/pinna, external auditory canal, tympanic membrane; collects and directs sound waves
- Middle ear: ossicles (malleus, incus, stapes), Eustachian tube; transmits and amplifies sound
- Inner ear: cochlea (hearing), semicircular canals (balance)
- Physiology: converts sound waves into nerve impulses (cochlea → auditory nerve → brain); maintains equilibrium
b) Assessment of Ear Function
History:
- Hearing loss, tinnitus (ringing), vertigo, pain, discharge, previous infections, trauma, occupational noise exposure
Ear Examination:
- Inspection of auricle, ear canal, tympanic membrane
- Palpation for tenderness or swelling
- Tuning fork tests: Rinne and Weber for hearing assessment
Diagnostic Tests:
- Audiometry: evaluates hearing loss
- Tympanometry: assesses middle ear function
- Otoacoustic emissions (OAE) and brainstem auditory evoked response (BAER): for newborn screening and neural hearing loss
c) Diseases and Disorders of Ear
1. External Ear Disorders
- Otitis externa: infection of external canal; care: cleaning, antibiotic ear drops, pain management
- Foreign body: removal with care to avoid trauma
- Impacted cerumen: softening agents, irrigation, manual removal
- Furunculosis: boils in ear canal; antibiotics, analgesics
2. Middle Ear Disorders
- Otitis media: infection of middle ear; care: antibiotics, analgesics, tympanostomy tube care
- Mastoiditis: infection of mastoid bone; care: antibiotics, surgery if required
- Perforation of tympanic membrane: protection from water, monitor for infection
3. Inner Ear Disorders
- Presbycusis: age-related hearing loss; hearing aids, patient education
- Labyrinthitis: inflammation causing vertigo; vestibular suppressants, bed rest, hydration
- Meniere’s disease: episodic vertigo, tinnitus, hearing loss; care: low-salt diet, diuretics, vestibular rehabilitation
- Otosclerosis: abnormal bone growth; care: surgery (stapedectomy), hearing aid
4. Deafness
- Conductive deafness: obstruction or middle ear pathology; care: treat cause, hearing aids
- Sensorineural (Neural) deafness: inner ear or nerve damage; care: hearing aids, cochlear implants
5. Tumors
- Benign or malignant growth in ear or auditory nerve; care: surgical preparation, postoperative care, rehabilitation
6. Insufflations of Eustachian Tube
- Used to relieve middle ear pressure; nursing care: patient education, monitoring for discomfort
NOSE
a) Review of Anatomy and Physiology of Nose
- External nose, nasal cavity, septum, turbinates, sinuses
- Functions: air passage, humidification, filtration, olfaction, resonance
b) Assessment of Nasal Function
History:
- Nasal obstruction, discharge, epistaxis (bleeding), loss of smell, trauma
Examination:
- Inspection for deformities, swelling, septal deviation, polyps
- Palpation of sinuses
Diagnostic Tests:
- Nasal endoscopy, CT scan of sinuses, culture of discharge
c) Diseases and Disorders of Nose
Infections:
- Rhinitis: inflammation; care: antihistamines, decongestants
- Sinusitis: infection/inflammation of sinuses; care: antibiotics, nasal irrigation
Obstruction:
- Polyps: surgical removal if needed
Foreign body: removal carefully
Deviated nasal septum: surgical correction if symptomatic
Trauma:
- Fractured nasal bone; care: pain relief, stabilization, monitoring for bleeding
- Epistaxis: control bleeding, topical vasoconstrictors, patient education
THROAT
a) Review of Anatomy and Physiology of Throat
- Pharynx (nasopharynx, oropharynx, laryngopharynx), larynx, tonsils, adenoids
- Functions: swallowing, speech, airway protection, immune defense
b) Assessment of Throat Function
History:
- Sore throat, dysphagia, voice changes, pain, bleeding, infections
Examination:
- Inspection of oral cavity, pharynx, tonsils, larynx
- Palpation for swelling, tenderness, lymph nodes
Diagnostic Tests:
- Throat swabs for culture, laryngoscopy, biopsy for tumors
c) Diseases and Disorders of Throat
Infections and Inflammation
- Tonsillitis: enlarged, inflamed tonsils; care: antibiotics, analgesics, post-tonsillectomy care
- Pharyngitis: sore throat, pain; care: hydration, antibiotics if bacterial
- Adenoiditis: enlarged adenoids; care: monitoring, surgical removal if obstructive
- Laryngitis: inflammation of vocal cords; care: voice rest, hydration, monitor for airway compromise
Tumors: benign or malignant; care: surgical preparation, post-op care, rehabilitation
Injury and Foreign Body: remove carefully, maintain airway, monitor for complications
Alternate Therapies
- Saline nasal irrigation
- Steam inhalation for congestion
- Herbal mouth rinses
- Voice therapy for laryngeal disorders
Drugs Used in Treatment of ENT Disorders
- Antibiotics: amoxicillin, azithromycin
- Antifungals: for fungal otitis externa
- Decongestants: pseudoephedrine, oxymetazoline
- Antihistamines: cetirizine, loratadine
- Analgesics: paracetamol, NSAIDs
- Corticosteroids: for severe inflammation, allergic rhinitis
- Mucolytics: acetylcysteine for sinusitis
Conclusion
ENT nursing involves comprehensive assessment, accurate diagnosis, infection prevention, pain management, surgical care, and patient education. Nurses also play a critical role in rehabilitation, hearing preservation, airway management, and supporting patients with chronic ENT disorders. Early intervention and proper nursing care improve outcomes and enhance quality of life.