We give you a thorough examination and offer effective treatment for a variety of ear disorders. We treat everything from simple wax buildup to chronic ear disease and disorders. If you suffer from dizziness, we can conduct balance testing to determine how to treat it.
Using Otomicroscopic Exams
Otomicroscopy, provides superior illumination and magnification and gives the clinician the freedom of both hands to examine the ear and for cerumen (earwax) removal.
Chronic ear infections and diseases
What is otitis media?
Otitis media refers to inflammation of the middle ear. When infection occurs, the condition is called “acute otitis media.” Acute otitis media occurs when a cold, allergy, or upper respiratory infection, and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube. This causes earache and swelling.
When fluid forms in the middle ear, the condition is known as “otitis media with effusion.” This occurs in a recovering ear infection or when one is about to occur. Fluid can remain in the ear for several weeks following an infection. If not treated, chronic ear infections have potentially serious consequences such as temporary or permanent hearing loss.
How does otitis media affect hearing?
A patient with a middle ear infection or fluid will have some degree of hearing loss. The average hearing loss in ears with fluid is 24 decibels…equivalent to wearing ear plugs. (Twenty-four decibels is about the level of the very softest of whispers.) Thicker fluid can cause much more loss, up to 45 decibels (the range of conversational speech).
A patient may have a hearing loss if he or she is unable to understand certain words and speaks louder than normal. Essentially, a patient experiencing hearing loss from middle ear infections will hear muffled sounds and misunderstand speech rather than incur a complete hearing loss.
Types of hearing loss
Conductive hearing loss is a form of hearing impairment due to a lesion in the external auditory canal or middle ear. Untreated middle ear fluid can lead to conductive hearing loss; draining fluid will usually return hearing to normal. Disorders of the middle ear bones or the tympanic membrane can lead to condustive hearing loss. Many of these disorders are correctable with surgery.
The other form of hearing loss is sensorineural hearing loss. This hearing loss is due to a lesion of the auditory division of the 8th cranial nerve or the deterioration of the inner ear. Historically, this condition is most prevalent in middle age and older patients; however, extended exposure to loud music can lead to sensorineural hearing loss in adolescents.
When should a hearing test be performed?
A hearing test should be performed for children who have frequent ear infections, hearing loss that lasts more than six weeks, or fluid in the middle ear for more than three months. Hearing testing should be performed for adults complaining of tinnitus, dizziness or hearing loss.
Do children lose their hearing for reasons other than chronic otitis media?
Children can incur temporary hearing loss for other reasons than chronic middle ear infection and Eustachian tube dysfunction. They include:
- Cerumen impaction: the buildup of layers of earwax within the earcanal to the point of blocking the canal and putting pressure on the eardrum. Ironically, cerumen impaction is often caused by misguided attempts to remove earwax.
- Swimmer’s Ear: Inflammation of the external auditory canal, also called “otitis externa.”
- Cholesteatoma: A mass of squamous cell epithelium and cholesterol in the middle ear, usually resulting from chronic otitis media.
Dizziness and balance disorders
Feeling unsteady or dizzy can be caused by many factors such as poor circulation, inner ear disease, medication usage, injury, infection, allergies, and/or neurological disease. Dizziness is treatable, but it is important for your doctor to help you determine the cause so that the correct treatment is implemented. While each person will be affected differently, symptoms that warrant a visit to the doctor include a high fever, severe headache, convulsions, ongoing vomiting, chest pain, heart palpitations, shortness of breath, inability to move an arm or leg, a change in vision or speech, or hearing loss.
What is dizziness?
Dizziness can be described in many ways, such as feeling lightheaded, unsteady, giddy, or feeling a floating sensation. Vertigo is a specific type of dizziness experienced as an illusion of movement of one’s self or the environment. Some experience dizziness in the form of motion sickness, a nauseating feeling brought on by the motion of riding in an airplane, a roller coaster, or a boat. Dizziness, vertigo, and motion sickness all relate to the sense of balance and equilibrium. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:
• The inner ear (also called the labyrinth), which monitors the directions of motion, such as turning, rolling, forward-backward, side-to-side, and up-and-down motions.
• The eyes, which monitor where the body is in space (i.e., upside down, right side up, etc.) and also directions of motion.
• The pressure receptors in the joints of the lower extremities and the spine, which tell what part of the body is down and touching the ground.
• The muscle and joint sensory receptors (also called proprioception) tell what parts of the body are moving.
• The central nervous system (the brain and spinal cord), which processes all the information from the four other systems to maintain balance and equilibrium.
The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.
The mastoid is a bone that makes up part of the posterior part of the temporal bone. It is located directly behind the ear. The mastoid may become inflamed or infected due to a perforation in the ear or an infection. Disorders affecting the mastoid usually have noticeable symptoms because the disorders may spread from the bone to other areas, causing growths in the inner ear, complications in hearing or ringing in the ears, and problems with balance. There are several disorders and infections associated with the mastoid which must be treated medically to ensure that they do not worsen with time.
Mastoiditis is an infection of the mastoid bone of the skull, which is located just behind the ear. Symptoms include drainage from the ear, ear pain and discomfort, a fever that may suddenly increase, headache, hearing loss, redness of the ear canal or behind the ear, or swelling of the ear, which may cause the ear to stick out. Mastoiditis is difficult to treat because antibiotics may not be able to penetrate deep enough into the ear to reach the mastoid bone. It may require long-term or repetitive medication. The medication may be injected into the ear or taken orally.
Tympanoplasty – Eardrum Repair
A hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear, is called a perforated eardrum. The medical term for eardrum is tympanic membrane. The middle ear is connected to the nose by the eustachian tube, which equalizes pressure in the middle ear.
A perforated eardrum is often accompanied by decreased hearing and occasional discharge. Pain is usually not persistent.
Middle ear infections may cause pain, hearing loss, and spontaneous rupture (tear) of the eardrum, resulting in a perforation. In this circumstance, there may be infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation. Symptoms of acute otitis media include a sense of fullness in the ear, diminished hearing, pain, and fever.
On rare occasions a small hole may remain in the eardrum after a previously placed pressure-equalizing (PE) tube falls out or is removed by the physician.
Most eardrum perforations heal on their own within weeks of rupture, although some may take several months to heal. During the healing process the ear must be protected from water and trauma. Eardrum perforations that do not heal on their own may require surgery.
Benign Paroxysmal Positional Vertigo (BPPV)
Cholesteatoma and Mastoid Surgery