* Are you taking any medications?
Rationale: Consider medications with possible ototoxic sequelae: aspirin, aminoglycosides (streptomycin, gentamicin, kanamycin, neomycin), ethacrynic acid, furosemide, indomethacin, naproxen, quinine, vancomycin.
6. Vertigo. Ever felt vertigo, that is, the room spinning around or yourself spinning? (Vertigo is a true twirling motion.)
Rationale: True rotational spinning occurs with dysfunction of labyrinth. Objective vertigo – feels like room spins. Subjective vertigo – person feels like she or he spins.
* Ever felt dizzy, like you are not quite steady, like falling or losing your balance? Giddy, lightheaded?
Rationale: Distinguish true vertigo from dizziness or lightheadedness.
6. Self-care behaviors. How do you clean your ears?
Rationale: Assess potential trauma from invasive instruments. Cleaning with cotton-tipped applicators can impact cerumen, causing hearing loss.
* Last time you had your hearing checked?
* If a hearing loss was noted, did you obtain a hearing aid? How long have you had it? Do you wear it? How does it work? Any trouble with upkeep, cleaning, changing batteries?
Rationale: Prescribe frequency of hearing assessment according to person’s age and/or risk factors.
ADDITONAL HISTORY FOR INFANTS AND CHIDLREN
1. Ear infections. At what age was the child’s first episode? How many ear infections in the last 6 months? How many total? How were these treated?
* Has the child had any surgery, such as insertion of ear tubes or removal of tonsils?
* Are the infections increasing in frequency, in severity, or staying the same?
* Does anyone in the home smoke cigarettes?
Rationale: If three or more episodes occur in the first 18 months of age, the child is “otitis-prone” and will have twice as many subsequent episodes as the child with one episode or no episodes during the first year. Passive or secondhand smoke is a risk factor for ear infections.
* Does your child receive child care outside your home? In a day car center or someone else’s home? How many children in the group care?
Rationale: Attendance at group day care, and bottle feeding compared with breastfeeding, are also risk factors for otitis media.