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These FAQs aim to provide information about ear health and hearing with links to further information.
The main types of OM are:
Three bacterial pathogens appear the be the main cause of otitis media:
Streptococcus pneumonia also refered to as pneumococcus is associated with the majority of otitis media cases particularly severe cases.
View information: Review of health and hearing among Indigenous peoples
A full set of answers can be found in The Ear video workbook - trainer version.
Source: The Ear Health and Education Unit at the Menzies School of Health Research and the Cooperative Research Centre for Aboriginal and Tropical Health
View information: Images of tympanic membrane
Source: Menzies School of Health Research
Designed as a educational exercise to improve abilities to:
Source: Ploof D, Kaleida PH, Children's Hospital of Pittsburgh of UPMC, Pittsburgh
Source: The World Health Organisation
View information: The WHO training resource on primary ear and hearing care
Determine what are the most common ear conditions in your population. If there is a high prevalence of eardrum perforations, you might need equipment to clean the canal, e.g. headlight, suction, ear canal instruments.
LumiView (Welch Allyn) or Voroscope (Vorotek): instruments which illuminate the ear canal and leave both hands free to use instruments. Models are either eyeglass-mounted (for individuals who need corrective lenses) or headband-mounted for general use in a clinic. Other uses include for suturing, taking Pap smear tests, etc.
If there is a high prevalence of OME (intact eardrums), pneumatic otoscopy and tympanometry are useful (tympanometry is not performed on ears with obvious pus or drum perforation)
Both techniques:
A pneumatic bulb is an inexpensive addition to the standard otoscope. The user needs training but it's quick to learn if they have basic otoscopy skills. Tympanometry is more expensive, needs a power source, the user needs training, it's harder to interpret and easier to make mistakes.
Source: Australian Medicare Local Alliance
The Aboriginal ear health manual (2008) provides information on the anatomy and function of the ear and preventive measures for ear problems. It details causes, types and effects of hearing loss together with common ear conditions. Diagrams and images are used to describe how to examine ears and algorithms for treatment strategies are provided.
View information: The Aboriginal ear health manual
The updated Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010 is designed to facilitate the delivery of comprehensive, effective and appropriate ear health programs. The guidelines provide practical treatment plans.
The guidelines are made up of 10 components:
The aim of all these components is to offer a series of clear recommendations that are:
The intended users of the guidelines are health professionals who work with Aboriginal and Torres Strait Islander populations. This includes Aboriginal Health workers, Aboriginal ear health workers, primary care and specialist physicians, nurses, remote area nurses and nurse practioners, audiologists, audiometrists, speech therapists, and child development specialists.
The guidelines recommend Ciprofloxacin for CSOM instead of Sofradex as there is a very small risk of ototoxicity (damage to the cochlea) from the active ingredients of Sofradex - refer to comparative trials referenced in the Guidelines.
Source: Australian Medicare Local Alliance
Sofradex should only be used for infections in the external canal, i.e. otitis externa/Swimmer's ear/Tropical ear (when the eardrum is intact), but not for CSOM.
Source: Australian Medicare Local Alliance
Ears can be syringed if there is profuse mucopus present in the canal or a foreign body such as an insect. Also, syringe to remove profuse soft wax or after using eardrops to soften impacted wax (if the eardrum is known to be intact).
Source: Australian Medicare Local Alliance
Impacted wax may need to be softened with eardrops, e.g. Cerumol, Waxsol, or a solution of bicarbonate of soda. Dry or soft wax and some foreign bodies can be removed with alligator forceps or a wax loop using a head-light or other illuminating/magnifying instrument. Tissue/toilet paper spears are the method of choice for families to remove pus discharge before putting in eardrops. If available in the clinic, suction can be used. Cotton buds are not effective for removing wax or discharge - they are too fat and not sufficiently absorbent.
Source: Australian Medicare Local Alliance
The Tissue spears: do it right DVD resource shows health personnel and families how to clean pus out of the ear using tissue spears. Diagrams, images and short videos are used to demonstrate. This resource should ideally be used by health professionals with clients and families so that they can help them understand some of the more complex ideas portrayed.
Source: Menzies School of Health Research
View information: The tissue spears: do it right DVD
Impacted wax may need to be softened with eardrops, e.g. Cerumol, Waxsol, or a solution of bicarbonate of soda. Dry or soft wax and some foreign bodies can be removed with alligator forceps or a wax loop using a head-light or other illuminating/magnifying instrument. Tissue/toilet paper spears are the method of choice for families to remove pus discharge before putting in eardrops. If available in the clinic, suction can be used. Cotton buds are not effective for removing wax or discharge - they are too fat and not sufficiently absorbent.
Source: Australian Medicare Local Alliance
The resources recommended for parents and carers are:
The resource materials are available to download from the Care for kids' ears website and hard copies of the resource materials can be requested using an online order form.
View information: Care for kids
Conductive hearing loss results from dysfunction of the outer or middle ear that interferes with the efficient transfer of sound to the inner ear. It is characterised by a loss in sound intensity.
Sensorineural hearing loss results from dysfunction in the inner ear (especially the cochlea). This is where sound vibrations are converted into neural signals. This type of hearing loss may also occur secondary to dysfunction of any part of the auditory nerve.
If a referred patient is found to have a significant hearing loss requiring hearing rehabilitation services, the audiology service (typically Australian Hearing) will manage the hearing review schedule to meet the individual's rehabilitation goals.
A patient with chronic ear disease who has adequate hearing on the first hearing test should still be considered at-risk for hearing loss and be referred again in 6 months if the ear condition has not improved. A patient should also have a review hearing assessment if there is a change in his/her ear state.
A patient should be referred for hearing assessment if the patient, family or teacher observes deteriorating responsiveness to sound.
Source: Australian Medicare Local Alliance
Basic hearing tests can be performed on children from the age of about five years in primary health clinics if there is suitable equipment, a quiet environment and a trained tester available. (See COMHeLP - the Audiology Australia Guidelines for more information).
Also, advise families and teachers to use clear communication (see Section E. Audiological), e.g. speak clearly and slightly more slowly, pause and wait for a response.
Source: Australian Medicare Local Alliance
Encourage families to stimulate verbal communication: talk to babies and children about what they are doing and what you are doing. Talk a lot - speak to them close up and in a clear voice. Tell stories, draw pictures, read books (with or without printed words). Accept and encourage all attempts at talking. Use other services, e.g. HIPPY, if available in your local area.
Source: Australian Medicare Local Alliance
Australian Hearing services include provision of hearing services to Aboriginal and Torres Strait Islander children and eligible adults. It produces a range of information fact-sheets and brochures on specific topics for Aboriginal and Torres Strait Islander communities including otitis media and sound-field systems in the classroom. The website also provides general information brochures on topics such as hearing loss, hearing aids and noise exposure.
Source: Australian Hearing
View information: Australian Hearing
An electro-ascoutic measurement of the stiffness, mass and resistance of the middle ear (more simply described as mobility of the eardrum). This test can be used to describe normal or abnormal middle ear function.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
The combination of simple otoscopy with the observation of eardrum movement when air is blown into the ear canal. Pneumatic otoscopy is able to determine mobility of the eardrum. Reduced mobility of an intact eardrum is a good indication of the presence of middle ear fluid.
Ear troubles is a book has been designed to help health workers and others talk to parents about conductive hearing loss.
View information: Ear troubles
Hearing rehabilitation starts with an assessment of hearing and hearing needs, so find out who in your area does this. See Further Learning, Resources for a list of State/Territory and National hearing services. See Commonwealth Hearing Services Program and Hearing Aid Bank.
Source: Australian Medicare Local Alliance
Myringotomy is a surgical incision in the eardrum to drain fluid.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
Myringoplasty is a surgical operation to repair a damage eardrum.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
Tympanoplasty is a surgical operation to correct damage to the middle ear and restore the integrity of the eardrum and bones of the middle ear.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
Grommets are also known as 'typanostomy tubes', 'ventilation tubes' or a 'PE tubes', they are small tubes surgically placed across the eardrum to re-establish ventilation to the middle ear.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
The updated Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010 is designed to facilitate the delivery of comprehensive, effective and appropriate ear health programs. The guidelines provide practical treatment plans.
Source: Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations 2010
The EarInfoNetwork yarning place enables people to share information, knowledge and experience with other people working in ear health around Australia.
Source: EarInfoNet
