SPECIALIST CONSULTATIONS
A Multidisciplinary team of Otolayrngologists, Audiologists, and Hearing Care Specialists evaluate and assess complex disorders of the ear. When referred to our team, ear disorders are managed with appropriate medical intervention.
COMMON EAR DISORDERS
Ear Infections
There are different types of ear infections and/or effusions, such as Acute Otitis Media (AOM), Otitis Media (OM) with Effusion, and Otitis Externa (OE). Otorrhea (aural discharge or drainage), aural fullness (pressure), and otalgia (ear pain) are common symptoms, however, tinnitus, hearing loss, and dizziness can also occur.
Acute Otitis Media (AOM)
Acute Otitis Media (AOM) occurs relatively suddenly due to bacteria or virus induced acute inflammation in the middle ear with rapid onset of otalgia. These infections commonly improve on their own or with the use of antibiotics.
Acute Suppurative Otitis Media (ASOM)
ASOM is a subtype of AOM characterized by pus in the middle ear, with accompanying discharge if the eardrum perforates.
Otitis Media with Effusion (OME)
OME involves middle ear inflammation of with fluid collected in the middle ear, but without signs or symptoms of acute infection. OME often occurs over several weeks or months and is commonly known as “glue ear.”
Chronic Suppurative Otitis Media (CSOM)
Chronic suppurative otitis media (CSOM) is a chronic middle ear mucosal inflammation with tympanic membrane perforation and otorrhea. CSOM is more difficult to treat and does not as readily respond to traditional treatments.
Acute Diffuse Otitis Externa
Acute Diffuse Otitis Externa occurs relatively suddenly due to bacterial or fungal induced acute inflammation of the external auditory canal. Common symptoms include otalgia and otorrhea. This type of infection is most commonly referred to as “swimmer’s ear,” and can be treated with antibacterial, antifungal, or steroid ear drops.
Chronic Otitis Externa
Chronic Otitis Externa is an infection of the external ear canal that persists despite traditional treatments. Inflammation, otalgia, and otorrhea are common symptoms. This type of infection can be bacterial or fungal. Symptoms are treated with traditional ear drops and routine ear cleanings.
Otorrhea (Aural Discharge)
Otorrhea and discharge can be classified under five different categories:
1. Purulent (pus)
2. Serous (protein-rich serum in blood)
3. Bloody
4. Mucoid (mucus)
5. Clear (thin and watery)
Eustachian Tube Dysfunction (ETD)
The Eustachian Tube connects the middle ear with the nasal-sinus cavity. This tube allows for pressure equalization and fluid drainage from the middle ear into the nasal-sinus cavity (or nasopharynx). Dysfunction of the Eustachian Tube can lead to ear infections, and eventually cause otorrhea, aural fullness, otalgia, hearing loss, tinnitus, and dizziness. Chronic Eustachian Tube Dysfunction can cause tympanic membrane retraction due to negative pressure in the middle ear and tympanic membrane perforations. Conservative treatments can include nasal sprays and rinses, however, if symptoms persist and become chronic, a myringotomy, tympanostomy tube, or Eustachian Tube Dilation procedure can be performed.
Tympanic Membrane Perforation
A perforation of the eardrum (or tympanic membrane) can occur due to physical trauma (such as with a Q-Tip or cotton bud) or an infection of the ear. Some perforations can heal on their own, but if they do not, a common surgical procedure known as a tympanoplasty is usually performed.
Cholesteatoma
A cholesteatoma is a cyst that invades the middle ear and sometimes the mastoid. There is an increased risk of cholesteatomas with
chronic Eustachian Tube Dysfunction due to retractions of the tympanic membrane. If cholesteatomas are left untreated
for too long, a surgical procedure known as a mastoidectomy may need to be performed.
Otosclerosis
Otosclerosis is a condition of abnormal hardening or stiffening of one or more ossicles in the middle ear which can cause Conductive hearing losses. There are three ossicles located in the middle ear known as the malleus, incus, and stapes. The most common surgical intervention is known as a stapedotomy.
Ménière’s Disease
Meniere’s Disease is a disorder of the inner ear and is also known as hydro/endolymphatic hydrops. There is increased hydraulic pressure within the inner ear (known as the cochlea) that can cause hearing loss, imbalance, and dizziness. Treatment and management of symptoms are the most common forms of intervention.
Superior Semicircular Canal Dehiscence (SSCD)
Superior Semicircular Canal Dehiscence is an abnormal thinning or incomplete closure of the bony canals of the inner ear. Most common symptoms are hearing loss, imbalance, and dizziness.
Acoustic Neuroma / Vestibular Schwannoma
An acoustic neuroma is a non-cancerous and usually slow growing tumour that develops on the vestibulocochlear nerve, and is monitored with routine MRIs of the Internal Auditory Canal. Common treatment procedures include excision or Gamma knife radiation. The most common symptoms are hearing loss, imbalance, and dizziness.
Sudden Sensorineural Hearing Loss (SSNHL)
Sudden Sensorineural Hearing Loss is an idiopathic or unexplained sudden loss of hearing. It is important to seek medical intervention as soon as possible to treat the hearing loss. Common treatments include oral steroids (ideally taken within 7 days of hearing loss onset) and intratympanic steroid injections. (ideally taken within 14 days of hearing loss onset).
COMMON OPERATIVE PROCEDURES
Eardrum Surgery
Common eardrum complications include perforations (holes in the eardrum) or eardrum retractions due to middle ear dysfunction. A tympanoplasty is the most common procedure to repair the eardrum (tympanic membrane). A cartilage, fat, or fascia graft is often used to during the tympanoplasty procedure.
Pressure Equalization, Tympanostomy, Ventilation Tubes
Plastic cylindrical tubes are surgically inserted through the eardrum to help drain excess fluid and equalize pressure from the middle ear. These procedures are used to treat ear infections of the middle ear, most commonly known as Otitis Media.
Middle Ear Surgery
Many complications can occur in the middle ear which may require corrective or preventative surgery. These procedures can include Ossicular Chain Reconstruction (OCR) surgery, cholesteatoma surgery, and mastoid surgery.
- Ossicular Chain Reconstruction can improve conductive hearing losses by replacing or repairing the damaged malleus or incus bones of the middle ear.
- A Mastoidectomy is removes diseased cells from the air-filled spaces in the mastoid bone. The mastoid is a part of your skull located behind your ear. This is a common procedure used to treat cholesteatomas, or ear infections, that have spread into the mastoid.
Laser Stapedotomy
The three smallest bones in the human body are the malleus, incus, and stapes which are located in the middle ear. Sometimes one or more of these bones can become stiff or fused, causing a conductive hearing loss. A laser stapedotomy is performed to improve hearing by correcting this fixation or fusion.
Eustachian Tube Dilation
Eustachian Tube Dysfunction often precedes and results in middle ear disorders. The Eustachian Tube is an opening that connects the middle ear to the nasal-sinus cavity allowing for drainage of fluids and pressure equalization. A dilation procedure can be performed to improve the function of the Eustachian Tube.
Canalplasty
A Canalplasty is often performed for patients with very narrow or non-existent ear canals. Excess cerumen blocking the canal is more common with narrow ear canals which can result in reduced hearing and infections. A Canalplasty can also be performed for patients with Exostoses, which are benign bony growths in the ear canal that may require excision or removal due to pain and/or hearing loss.
DEFINITIONS
“Excellent Doctor and staff. Very kind, caring and
knowledgeable doctor and staff. Dr.Ho is an Outstanding
surgeon too. Very thankful I got in for my surgery when I did.
You all are a blessing and I’m so thankful for you all.”
Google Reviews
“Just over month ago I experienced a sudden loss of hearing
in one of my ears (Complete hearing loss), and as soon as I
was referred to Dr Ho, I had an appointment and treatment
was initiated. The staff and Dr Ho have been very helpful,
encouraging, and compassionate throughout this process…”
Kelli – Google Reviews
Questions?
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