Hearing Loss Procedures
Hearing loss is the 3rd most common health problem. There are different types of hearing loss. Some can be improved with surgery while others cannot. Appropriate treatment for hearing loss depends on complete evaluation of a patient’s medical history, physical exam of the ear and audiologic testing. The Indigo ENT group works closely with skilled audiologists and hearing aid specialists to offer the best evaluation and treatment according to your type of hearing loss.
A tympanostomy tube (also known as a grommet, T-tube, ear tube, pressure equalization tube, vent, PE tube or myringotomy tube) is a small tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time, and to prevent the accumulation of fluid in the middle ear. This can be safely performed under local anesthesia in the office for adult patients. Pediatric patients generally require sedation in the hospital.
Tympanoplasty, also called middle ear repair, refers to surgery performed to reconstruct a perforated tympanic membrane (eardrum) and/or the small bones of the middle ear. Eardrum perforation may result from chronic infection, inflammation, cyst/tumor formation, chronic negative pressure, tubes or trauma. This is a very effective procedure but does depend on the size and location of the perforation. Results also depend on whether there is any middle ear scarring or middle ear bone abnormality that is related.
This procedure is typically performed under general anesthetic in the hospital setting.
Myringoplasty simply means patching of the ear drum. For certain perforations, this can be the ideal in office surgery performed under local anesthetic. It can use a combination of fat or cartilage as well as the aid of the Epidisc to help close a perforation. Ask your specialist about the benefits of this procedure and if it is appropriate for you.
A mastoidectomy is a surgical procedure that removes diseased mastoid air cells. These cells sit behind your ear in a hollow space in your skull. The diseased cells are often the result of an ear infection that has spread from your ear and requires surgical drainage if maximal medical treatment has not been successful. Mastoidectomy may also be performed along with tympanoplasty in cases where ear cysts (cholesteatoma) extend from the middle ear to the mastoid. In this case the mastoidectomy can help to ensure complete disease removal. Mastoidectomy is performed under general anesthesia in the hospital setting.
An ossicular chain reconstruction is an operation to repair, reconstruct and improve the movement of the tiny bones of hearing in the middle ear. These bones may have become damaged or less mobile due to infection or disease such as long-standing middle ear infection (chronic otitis media), trauma such as a head injury or previous surgery, from a tympanic membrane retraction or cyst (cholesteatoma) or even from genetic causes, in some cases. Talk to your specialist about whether this procedure is right for you.
In the event of a sudden hearing loss, it is important to receive urgent treatment with oral steroids with or without an antiviral medication for 7-10 days. Research has shown improved hearing recovery if treatment is initiated within 72 hours of the onset of the hearing loss. If the hearing loss persists, a liquid steroid medication (dexamethasone) can be injected through the ear drum into the middle ear space. This has been shown through research to improve the rate of hearing recovery in up to 40% of patients who failed to respond to oral therapy. The procedure is completed in the office using topical anesthetic on the ear drum called phenol. A series of weekly injections is performed (up to 4 weeks) until full hearing recovery is demonstrated. Complications are rare including ear drum perforation, ear infection, temporary dizziness and ear fullness.
Sudden Sensorineural Hearing loss
Sudden sensorineural hearing loss (SSNHL), commonly known as sudden deafness, occurs as an unexplained, rapid loss of hearing—usually in one ear—either at once or over several days. It should be considered a medical emergency. Anyone who experiences SSNHL should visit a doctor immediately. Sometimes, people with SSNHL put off seeing a doctor because they think their hearing loss is due to allergies, a sinus infection, earwax plugging the ear canal, or other common conditions. However, delaying SSNHL diagnosis and treatment may decrease the effectiveness of treatment.
Nine out of ten people with SSNHL lose hearing in only one ear. SSNHL is diagnosed by conducting a hearing test. If the test shows a loss of at least 30 decibels (decibels are a measure of sound) in three connected frequencies (frequency is a measure of pitch—high to low), the hearing loss is diagnosed as SSNHL. As an example, a hearing loss of 30 decibels would make conversational speech sound more like a whisper.
Many people notice that they have SSNHL when they wake up in the morning. Others first notice it when they try to use the deafened ear, for example when going to use a phone. Still others notice a loud, alarming “pop” just before their hearing disappears. People with sudden deafness may experience dizziness, have ringing in their ear or both.
About half of people with SSNHL will recover some or all of their hearing spontaneously, usually within one to two weeks from onset. Treatment is best received within 72 hours of developing the hearing loss.
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