Tell a Friend
captcha

 
x

Ear

We are proud to offer the following audiologic services:

  • Newborn hearing evaluations
  • Pediatric and adult comprehensive hearing evaluations
  • Balance and dizziness testing*
  • Dispensing and fitting of hearing aids for all ages
  • Bone anchored hearing aid services (including trial, surgery & programming)
  • Central Auditory Processing Disorder (CAPD) evaluations*
  • Cochlear implant programming
  • Tinnitus (ringing or buzzing in the ear) evaluations and management
  • Concussion evaluations and management
  • Dispensing and fitting of assistive listening devices and hearing aid accessories
  • Custom hearing protection for noise management, including hunter’s earplugs
  • Custom swimmer’s earplugs for water precaution

*These services are currently only available at our Altoona location

Please see below for information on hearing loss and balance disorders.

Hearing problems

Hearing loss is the partial or total loss of hearing in one or both ears. Loss of hearing can be temporary or permanent. Several disorders can affect the hearing in adults as well as children. If left untreated, hearing loss can have a significant impact on your employment, education, relationships and general well-being. Please click here for a hearing loss check list to help determine if you may need a hearing evaluation by an audiologist.

Types

The 3 common types of hearing loss include:

  • Conductive hearing loss: This is the condition where the sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones of the middle ear (ossicles).
  • Sensorineural hearing loss: This is the most common type of permanent hearing loss, resulting from damage to the tiny hair cells or to the nerve endings from the inner ear to the brain.
  • Mixed hearing loss: This type of hearing loss occurs in people who have both conductive and sensorineural types of hearing loss.

Causes

Hearing loss can be congenital (present at birth) or acquired (may appear later). Common causes of conductive hearing loss include, ear infections, middle ear fluid, allergies, perforated eardrum, ear canal infection, benign tumors, impacted earwax, and anatomic abnormalities.

Some of the possible causes of sensorineural hearing loss include, illness, aging, head trauma, prolonged exposure to loud noises, certain drugs, and inner ear malformation.

Symptoms

Hearing loss may be gradual or sudden, can range from mild to profound, and may involve one or both ears. Symptoms may include, dull hearing, difficulty understanding speech, ear pain, ringing or buzzing in the ear, itching, drainage, and vertigo (dizziness). Other symptoms include need for high volume when listening to the radio or television, avoiding social situations, and depression. Tinnitus (ringing or buzzing in the ear) maybe present with or without significant hearing loss and occur in one or both ears. Please click here for more information on tinnitus.

Diagnosis

Your doctor will diagnose hearing loss by asking about your symptoms and with a detailed physical examination of the ears using an instrument called otoscope. Your doctor may also recommend hearing evaluation that may comprises of:

  • Pure tone audiometry: This test determines how well a person can hear sound travelling through the ear canal and through the skull.
  • Speech reception and word recognition tests: To check your ability to hear and understand speech.
  • Acoustic immittance tests (tympanometry): This test evaluates the eardrum’s  and middle ear’s ability to receive sound energy.
  • Otoacoustic emissions (OAE) testing: This test measures the sounds given off by the inner ear.
  • Auditory brain stem response (ABR) testing: This objective test may be administered to test the auditory nerve pathways in the brain.
  • Tuning fork test: This test helps to differentiate conductive hearing loss from sensorineural hearing loss with the help of tuning fork.

When an injury or tumor is suspected other imaging techniques such as CT or MRI scan of the head may be done.

Treatment

Treatment for temporary or conductive hearing loss depends on its cause and is often treated successfully. An ear infection is treated with the antibiotics, and blocked ear with earwax is treated by removing the wax using special instruments. Corticosteroids may be used in the case of sudden sensorineural hearing loss.  If medical and/or surgical treatment is unsuccessful in correcting a temporary or conductive type hearing loss, then hearing devices (such as traditional or bone anchored hearing aids) may be a treatment option.

In the case of permanent hearing loss, hearing devices (such as traditional hearing aids) or hearing implants (such as bone anchored hearing aids or cochlear implants) may be used to restore your hearing and to help you communicate more easily. If a hearing loss presents as severe-to-profound or worsens to a severe-to-profound hearing loss, then a cochlear implant may be an option; however, further testing is needed prior to pursuing such options.

A cochlear implant is a small complex electronic device that is surgically placed within the inner ear to help transmit sound via an electrical signal. It consists of external components (a microphone, a speech processor, and a transmitter) and an implanted component (a receiver/stimulator, and an electrode array). The microphone picks up sound from the environment and sends the signal to a speech processor which selects analyses and digitizes the sound signals before they are sent to a transmitter. This in turn transmits these digitized sound signals via radio waves to the internal implant where the fibers of the auditory nerve are electrically stimulated and sound sensations are perceived. Please click here for more information on cochlear implants.

Dizziness & balance problems

Dizziness means feeling light-headed or the feeling of imbalance or unsteadiness, and is a nonspecific term. Lightheadedness is a feeling of fainting and may be due to low blood pressure, illness, or other factors.  Vertigo is a feeling of spinning sensation with loss of balance and may be due to a balance disorder within the inner ear.

Causes

Dizziness is often caused by decreased blood supply to the brain and the impaired blood supply may be because of low blood pressure or dehydration which may be caused by diarrhea, fever, and vomiting. Elderly people may experience lightheadedness when they get up quickly from a lying or seated position. Lightheadedness may also be associated with flu, low blood sugar, sweating, and common cold. Vertigo is often associated with inner ear problems or disorders. Other conditions that lead to dizziness include heart problems and stroke and in these cases patients may also develop symptoms like chest pain, loss of speech, and change in vision.

The most common causes of vertigo may include:

  • Benign paroxysmal positional vertigo (BPPV) – The crystals in the inner ear become dislodged and move to one of the semicircular canals and cause irritation. It is caused because of sudden positioning of the head and most commonly occurs in older people.
  • Labyrinthitis – Is an ear disorder that involves inflammation of the balance organ in the inner ear which commonly occurs after a viral infection.
  • Meniere’s disease – Is an inner ear disorder that causes severe hearing loss, ringing in the ears and dizziness. The disease can affect one or both ears.
  • Acoustic neuroma – Is a benign tumor of the ear causing ringing in the ears, hearing loss and dizziness and balance problems.
  • Trauma to the inner ear
  • Barotrauma causes damage to the inner ear and vertigo due to pressure changes between the middle and inner ear.

Symptoms

You may feel spinning sensation associated with loss of balance and unsteadiness. Other symptoms include decreased hearing and ringing in the ear (tinnitus). Nausea and vomiting may be also associated with vertigo causing dehydration and weakness.

Diagnosis

Your doctor will perform a thorough physical examination and may ask you about the associated symptoms and past medical history. Hearing tests may be recommended to make sure that that the middle ear, the cochlea, and the auditory nerve are functioning accurately. Additional specialized diagnostic testing may be ordered to help determine the source or cause of the vertigo.

Treatment

Dizziness is a symptom and not a disease and if it is not treated at the right time, it may lead to serious health problems.

Treatment includes treating underlying disease conditions, for example:

  • Dehydration – Drink more amounts of liquids or fluids and in cases where you are unable to drink water then intravenous administration may be preferred
  • Fever or infection – Medications for fever or antibiotics to treat infections may be prescribed
  • If dizziness is due to heart conditions or anxiety related disorders necessary treatment may be initiated
  • Vertigo from BPPV or labyrinthitis is often treated with vestibular rehabilitation exercises, also referred to as Epley manoeuvres. It involves positioning and manipulating the patients head to remove the crystals from the semicircular canals and thus reducing the inflammation.
  • Medications such as stemetil may be prescribed to reduce the vertigo symptoms inflammation within the vestibular system
  • Corticosteroids and antiviral medications such as acyclovir or valacyclovir may be prescribed for viral infections causing the labyrinthitis
  • Surgery may be needed in patients with acoustic neuroma or other anatomical disorders of the ear.

Ear Infection

The ear is composed of outer, middle, and inner parts. The eustachian tube connects the middle ear to the postnasal space. It helps to ventilate the middle ear. Infection can affect the ear canal (otitis externa), the middle ear, or the inner ear.

The most common infection in adults is outer ear infection (otitis externa).

Causes

The most common cause of outer ear infections is water exposure after minor trauma of the ear canal (cotton buds, scratching etc). Other causes include use of hearing aid, eczema, and diabetes. Some common causes of middle ear infections include allergies, illness, and Eustachian tube dysfunction.

Treatment

The best treatment is microsuction by your friendly ear surgeon in conjunction with ear drops.

Ear Tubes

Coming soon

Hearing Loss


Hearing loss is the partial or total loss of hearing in one or both ears. Loss of hearing can be temporary or permanent. Several disorders can affect the hearing in adults as well as children. If left untreated it can have a significant impact on your employment, education, and general well-being. There are three common types of hearing loss including conductive hearing loss, sensorineural hearing loss, and mixed hearing loss. Ear infections can cause a hearing loss and are the most common source of temporary and conductive hearing loss.

  • Conductive hearing loss: This is the condition where the sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones of the middle ear (ossicles).
  • Sensorineural hearing loss: This is the most common type of permanent hearing loss, resulting from damage to the tiny hair cells or to the nerve endings from the inner ear to the brain.
  • Mixed hearing loss: This type of hearing loss occurs in people who have both conductive and sensorineural types of hearing loss.

Causes of Hearing Loss

Hearing loss can also be congenital (present at birth) or acquired (may appear later). Common causes of conductive hearing loss include, ear infections, middle ear fluid, allergies, perforated eardrum, ear canal infection, benign tumors, impacted earwax, and anatomic abnormalities.

Some of the possible causes of sensorineural hearing loss include, illness, aging, head trauma, prolonged exposure to loud noises, certain drugs, and inner ear malformation.

Symptoms

Hearing loss may be gradual or sudden and may be mild or severe and may involve one or both ears. Symptoms may include, dull hearing, difficulty understanding speech, ear pain, ringing or buzzing in the ear, itching, drainage, and vertigo (dizziness). Other symptoms include need for high volume when listening to the radio or television, avoiding social situations, and depression.

Diagnosis

Your doctor will diagnose hearing loss by asking about your symptoms and with a detailed physical examination of the ears using an instrument called otoscope. Your doctor may also recommend hearing evaluation that may comprises of:

  • Tuning fork test: This test helps to differentiate conductive hearing loss from sensorineural hearing loss with the help of tuning fork.
  • Pure tone audiometry: This test determines how well a person can hear sound travelling through the ear canal and through the skull.
  • Speech reception and word recognition tests: To check your ability to hear and understand speech.
  • Acoustic immittance tests (tympanometry): This test evaluates the eardrum’s and middle ear’s ability to receive sound energy.
  • Otoacoustic emissions (OAE) testing: This test measures the sounds given off by the inner ear.
  • Auditory brain stem response (ABR) testing: This objective test may be administered to test the auditory nerve pathways in the brain.

When an injury or tumor is suspected other imaging techniques such as CT or MRI scan of the head may be done.

Treatment

Treatment for temporary or conductive hearing loss depends on its cause and is often treated successfully. An ear infection is treated with the antibiotics, and blocked ear with earwax is treated by removing the wax using special instruments. Corticosteroids may be used in the case of sudden sensorineural hearing loss.  If medical and/or surgical treatment is unsuccessful in correcting a temporary or conductive type hearing loss, then hearing devices (such as traditional or bone anchored hearing aids) may be a treatment option.

In the case of permanent hearing loss, hearing devices (such as traditional hearing aids) or hearing implants (such as bone anchored hearing aids or cochlear implants) may be used to restore your hearing and to help you communicate more easily. If a hearing loss presents as severe-to-profound or worsens to a severe-to-profound hearing loss, then a cochlear implant may be an option; however, further testing is needed prior to pursuing such options.

A cochlear implant is a small complex electronic device that is surgically placed within the inner ear to help transmit sound via an electrical signal. It consists of external components (a microphone, a speech processor, and a transmitter) and an implanted component (a receiver/stimulator, and an electrode array). The microphone picks up sound from the environment and sends the signal to a speech processor which selects analyses and digitizes the sound signals before they are sent to a transmitter. This in turn transmits these digitized sound signals via radio waves to the internal implant where the fibers of the auditory nerve are electrically stimulated and sound sensations are perceived.

Hearing Problems & Glue Ear


In healthy children, the middle ear is filled with air, but if your child has an infection, chronic ear disease or obstruction of the Eustachian tube, fluid or mucous will accumulate.

Hearing problems can be congenital or acquired. Congenital causes include genetic defects. Acquired causes include ear infections, meningitis, measles, chicken pox, influenza, head injury, and ototoxic drugs. Hearing problems can be temporary or permanent.

In New South Wales all children are screened for hearing problems at birth with the SWISH (statewide infant screening for hearing) program. Early intervention for hearing deficits is vital to establish the pathways for speech and language development.

Glue ear

Glue ear is a condition where excess mucous (glue) accumulates in the ear instead of air. This fluid interrupts the passage of sound into the ear leading to a conductive hearing loss.

Causes

Children are at more risk of developing glue ear because the eustachian tube does not function as well as in adults and can be easily obstructed. If your child is allergic to pets or dust, then the risk of developing glue ear is higher because inflammation caused by the allergic reaction results in swelling and blockade of the eustachian tube.

Enlarged or infected adenoids may also block the eustachian tube. Adenoid glands are situated at the back of the nose and throat that fight against germs and bacteria which invade the body.

Symptoms

Inattention, frustration, hearing loss, delayed speech and language development

Diagnosis and treatment

Your Paediatric ENT doctor primarily examines your child’s ear by an instrument called an otoscope. In addition, an audiogram (to check if your child can hear) and tympanogram (to check the compliance and movement of the eardrum) may be required.

Several options are available for the management of glue ear.

Watchful waiting for 3 months.

Surgical placement of ventilating middle ear tubes (grommets).

Surgery may also be performed to remove the adenoid gland if there is evidence of nasal obstruction at the time of the first grommet surgery, or if a second set of grommets is required.

Cholesteatoma

This condition is defined as skin growing in the middle ear cleft. There should not be any skin in the middle ear, because it is lined by mucosa. If skin grows in the middle ear it can erode vital structures, cause permanent hearing loss, balance disorders and can extend into the cranial cavity and brain. The cholesteatoma can erode into the facial nerve and cause a facial palsy.

The most common symptoms of cholesteatoma are offensive smelling discharge from the ear, chronic ear infections, and hearing loss. Other symptoms can include facial weakness, disturbance of balance, and buzzing in the ear (tinnitus).

The treatment of cholesteatoma is with surgery. Long term follow up is required to ensure that there is no recurrence of the disease.

Tinnitus and Dizziness

Tinnitus is referred to as a ringing or roaring sound that occurs in one or both ears. The sound may be soft or loud, high pitched, or low pitched. Tinnitus can occur at any age in children and adults. The presence of tinnitus in children over a long period of time may be considered normal to them and your child may fail to complain about the problem.

Causes

Tinnitus most commonly results from damage to the microscopic endings of the hearing nerve in the inner ear. Injury to these endings further causes hearing loss. Exposure to loud noises and side effects of certain medicines such as anti-inflammatory, antibiotics, sedatives, antidepressants, and aspirin can also cause tinnitus. Tinnitus may also be caused by other conditions such as ear blockage, ear and sinus infections, allergies, high or low blood pressure, tumors, problems in the heart or blood vessels, Meniere’s disease, and thyroid abnormalities.

Symptoms

A buzzing or ringing type of sound is heard in the ear which can be continuous or intermittent and vary in pitch from a low sound to a high pitched sound. It may be accompanied by a syndrome known as Meniere’s disease. Meniere’s disease is an inner ear disorder that causes severe hearing loss, ringing in the ears, and dizziness.

Diagnosis

Your doctor will diagnose tinnitus by a thorough physical examination and asking about your child’s medical history. Additional tests such as a complete hearing test (audiogram), brain scan such as MRI or CT scan may be required to confirm the condition.

Spinal tap test may also be required to evaluate the fluid pressure in the skull and spinal cord.

Treatment

Treatment options for tinnitus include:

  • Counseling: Many children dealing with tinnitus may get worried about them being the only ones affected with this problem. Educational counseling will help your child understand and change their approach towards tinnitus.
  • Hearing aids: These devices help in correcting hearing loss in children with tinnitus. These devices help to control the outside sound and make it easier to hear.
  • Wearable sound generators: These are small electronic devices placed in the ear which will mask the tinnitus by using a soft pleasant sound.
  • Tabletop sound generators: In this a generator is used to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night to help your child relax or fall asleep.
  • Acoustic neural stimulation: It is a new technique for people who experience very loud ringing sounds. It involves the use of a palm-sized device and headphones that play music which is embedded with a broadband acoustic signal. This treatment will stimulate the change in the neural pathways and allow the brain to become desensitized to the sound.
  • Cochlear implant: The cochlear implant helps to mask tinnitus and stimulates fibers of the auditory nerve.
  • Antidepressants and antianxiety drugs may be recommended to relax and help to sleep.

Prevention

Some of the preventive tips to reduce or lessen the severity of tinnitus are:

  • Avoid exposure to loud sound and noise
  • Blood pressure should be regularly checked and controlled
  • Routine exercises to improve your circulation
  • Avoid worrying about the noise

Tinnitus is a common childhood problem which can unknowingly bother your child for a long time. For children who are affected with tinnitus, various options of support and therapies are available to help the child cope with the condition.

Ear Reconstructive Surgery

Coming soon

Meet Our Providers

Robert DeFatta

Robert J.DeFatta
M.D. PhD

Facial Plastic Surgeon

Read more

Rima Abraham

Rima A. DeFatta
M.D.

Otolaryngologist

Read more

Services