Geriatric ear, nose, and throat problems

Clarence Fred Gehris, Leonard Proctor, Lauren G. Collins

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

It is important to check carefully for a number of problems among elderly patients, who may be unaware of the insidious development of hearing loss, balance deficits, or intraoral or pharyngeal cancers. Unsuspected balance deficiencies may be putting the patient at risk for falls. Nasal obstruction may be dismissed by the patient; however, inspection may reveal easily treatable problems such as benign polyps or life-threatening disease such as a neoplasm. Outer Ear: The anterior and posterior surfaces of the pinna are common sites for actinic keratoses and skin cancers. The eardrum, especially the pars flaccida, is a common location for an occult cholesteatoma (see later). If cerumen obstructs the examiner's view it can be removed by direct manipulation or by irrigation with clean water at body temperature, provided there is no eardrum perforation. Alternatively, instilling mineral oil will soften and lubricate the impaction, making removal easier and more comfortable. Cerumen impaction can usually be avoided by keeping the ear oily (by adding a couple of drops of mineral oil weekly) and keeping soapy water away from the ear canal. Swelling of the external auditory canal associated with purulent secretions indicates an external otitis. External otitis should be treated by applying eardrops containing an antibiotic (typically polymyxin and neomycin combined with hydrocortisone) in an acidic solution. Cortisporin, Coly-mycin or VoSoL are commonly used preparations. Drops should be applied three times daily. It is important that a) the canal orifice should be cleared of secretions and debris before the application and b) the patient's head must be adjusted so that the ear canal is tilted upward.

Original languageEnglish (US)
Title of host publicationReichel's Care of the Elderly
Subtitle of host publicationClinical Aspects of Aging, Sixth Edition
PublisherCambridge University Press
Pages424-434
Number of pages11
ISBN (Electronic)9780511575952
ISBN (Print)9780521869294
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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