The Ear

The ear is a complex organ with multiple functions. It is responsible for hearing and sound localization. It is a key component for balance and moving the eyes. Additionally, important structures move through the ear such as the nerve that moves the facial muscles, the nerve for taste which goes to the tongue, the carotid artery and the jugular vein. The ear also shares some features of the sinuses in that it is an air filled space, so it can be prone to infection just as the sinuses can. Given the important structures involved with the ear, it is no surprise that it is affected by a number of problems.

Common disorders of the ear which we treat include:

    • Hearing loss can be caused by a number of problems. It may be a simple as wax blocking the ear canal. It is commonly seen in children due to fluid in the ear, but this can occur in adults as well. It can be caused by impaired mobility of the ear bones. Most commonly in adults, it is related to deterioration of the ear nerve. In most cases, there is a great deal that can be done to rehabilitate hearing either through medications, procedures or hearing aids. It is important to note that any sudden hearing loss should be evaluated as soon as possible, as in cases of sudden nerve hearing loss, there is limited time for rescuing the nerve. Regardless of the cause, we have state of the art equipment to test your hearing, your middle ear function, and your auditory nerve function.

    • Tinnitus is the perception of abnormal sounds in the ear. It may be a buzzing, humming, chirping, or ringing. In some cases it may sound like your heartbeat. Tinnitus is very common, and in most cases suggests some degree of hearing loss. Sudden onset of tinnitus should be worked up with a hearing test and may require an imaging study.

    • Dizziness is a complex issue and one that we are happy to help you with. There are many causes of hearing loss and your evaluation will start with determining the quality of your dizziness. Dizziness can present as "Vertigo" which is the perception of swirling motion. It is usually associated with nausea and vomiting. Dizziness can also be imbalance, lightheadedness, feeling faint, or even a sense of feeling disconnected from the body. In most cases, vertigo is an ear problem. However, other types of dizziness can be challenging to assess. Our balance laboratory features equipment to measure your brain and ear related balance function.

    • Recurrent Ear Infections are a condition that many parents are well aware of. In most cases, when antibiotics fail, the patient's doctor will refer patients in for tube placement. This is the most common surgery done on children and it tends to not only decrease the number of infections, but correct hearing loss associated with fluid in the ears that can lead to speech delay. Some adults also have ear infections. This is much more unusual than in children and generally should be worked up to assess the source of the infection. This will include a microscopic evaluation of the ear drum, and in many cases a fiberoptic evaluation of the opening of the eustacian tubes in the back of the nose.

    • Perforation of the Ear Drum is not unusual in the case of ear infection, but when they do not heal spontaneously, they can be a source for infection and a component of hearing loss. In many cases we can repair holes in the ear drum.

    • Cholesteatoma is a condition where a patient's skin cells are growing behind the ear drum. Just like skin cells on the body have debris that we wash away, these cells in the ear also produce this debris leading to a cyst. With time, this cyst can expand and create serious problems. Usually a cholesteatoma has no symptoms until the ear starts to drain or the hearing becomes impaired. Cholesteatomas are generally removed surgically.

    • Exostosis is a common condition we see on the Cape since our population tends to love swimming. It is a condition where the ear canal slowly becomes blocked by bone growths. It is generally associated with individuals who swam frequently in cold water when they were yourg which is why it is also known as "surfer's ear". This can be corrected with a day surgery when it becomes severe.

    • Otosclerosis is an interesting condition in which the ear bones slowly remodel over time leading to impaired motion. In many cases it can be corrected with surgery. This is a hereditary condition that can skip generations. A hearing test can help to determine if your hearing loss is due to this.

    • This is generally regarded as an emergency. Sudden hearing loss in one or both ears is important to have assessed quickly. While it may be due to wax or fluid in the middle ear, in some cases it is due to a failing nerve. In this case it is vital that we get you on treatment as soon as possible.

    • This is simply wax in the ear. This is a normally produced substance that your ear makes to protect itself, just as the eye makes tears. It is not dirt and has nothing to do with hygiene, so it is nothing to be ashamed of. We seem many patient's for routine wax cleaning just as patients go to their dentist for removal or tartar from the teeth.

We have invested heavily into technology to assist with the diagnosis of you or your child's hearing or balance problems.

We are able to offer the following services:

  • Comprehensive Audiometry (standard hearing test battery for most situations)
  • Tympanometry (Test of middle ear function)
  • Videonystagmography (Test of your brain and inner ear balance function)
  • Caloric Testing (Test of your inner ear balance function)
  • Active Head Rotation Testing (Test of inner ear balance function)
  • Auditory Brainstem Response Testing (Test of auditory function along the ear nerve and brain that can be used to test hearing in newborns)
  • Vestibular Evoked Myogenic Potential Testing (Test of a sound induced reflex)
  • Distortion Product Otoacoustic Emission Testing (Test of Inner Ear Function)
  • Electrocochleography ( Test of cochlear function)
  • Visual Response Audiometry (Hearing testing in infants)
  • Force Plate Testing (Clinical Test of Sensory Integration in Balance)

While most ear problems are managed medically, there are times when surgery can help.

We offer the following ear surgeries:

    • This is a procedure in which we place a tiny grommet in the ear drum to allow fluid to drain and equalize the middle ear pressure. This is the most common procedure performed on children and can be done in the office in adults. It is often used to treat chronic middle ear fluid and recurrent ear infections.

    • This is a procedure to repair an ear drum with a hole in it. It can be performed in a variety of ways from a simple in office patch to a more complex procedure in the operating room using a laser to weld donor material onto the drum.

    • In this procedure, the bone behind the ear is cleaned out. This is most commonly done for chronic infection or cholesteatoma.

    • Reconstruction of the outer ear canal.

    • Placement of an osteointegrated implant into bone behind the ear to allow use of an external hearing device.

    • Used for sudden hearing loss or for menieres disease.