Myringotomy tubes, commonly known as ear tubes, are usually placed for recurrent ear infections or persistent middle ear fluid. Ear tubes can significantly decrease the number of ear infections, improving hearing and pain during an infection as well as allow for the infection to be treated with antibiotic ear drops instead of oral antibiotics. Side effect of ear tubes are limited, the most common of which involves increased ear drainage or a persistent hole in the ear drum after the tube has extruded. Most tubes will extrude on their own in 6-12 months and can be taken out of the ear canal in the office.
A variety of methods of hearing testing can be used depending on the age and cooperation of the patient. Hearing testing is performed in our office daily by our audiologist Dr. Perry. For more information about the various types of hearing testing available and hearing aids click here. (link to hearing center)
Excessive cerumen (earwax) can be removed a number of ways. Ear drops can soften and sometimes dissolve the cerumen allowing it to empty out on its own. When this becomes problematic usually physical removal is the solution. Frequently this is done under the microscope with suctions and delicate instruments to minimize discomfort. Occasionally water is used to flush the remaining cerumen out.
There are conditions which intratympanic steroid injections have shown benefit including sudden hearing loss and exacerbations of vertigo attacks for patients with Meniere’s disease. This is typically done as a course of 3 injections 1-2 weeks apart with a highly concentrated steroid which penetrates the inner ear. Side effects can include transient dizziness and a small risk of persistent hole in the ear drum. There are no systemic side effects with this treatment unlike oral steroids.
Conventional hearing aids are the best solution for most people with a significant hearing loss. There are situations however when due to frequent drainage or a large ear canal from surgery that wearing a conventional hearing aid is difficult. Bone anchored hearing aids can be implanted with a small outpatient procedure and bypasses the eardrum and hearing bones to give a signal directly to the cochlea. This can be a good option for people who have had certain types of chronic ear disease or one ear which is completely deaf with normal hearing in the other ear. A demonstration device is available to try for interested candidates.
A hole in the eardrum known as a tympanic membrane perforation can lead to hearing loss as well as recurrent infections. This can keep you from water activities which lead to infection. Perforations can be “patched” in a number of ways. Most commonly this is done in the operating room as an outpatient procedure. A graft is taken from the lining of the muscles above the ear and used to cover the hole as the eardrum heals onto the graft and over the hole. For select patients with small hole a small piece of fat can be used to patch the hole. Sometimes this can be done as an in office procedure without general anesthesia.
Earrings that pull through the earlobe are a common occurrence. This can both cause a deformity and limit placement of earrings. These can be repaired with a brief in-office procedure. To wear earrings again in that ear, complete healing must take place first and then the ears can be pierced again.
Protruding ears can be a cause of ridicule and bullying particularly in younger children. Otoplasty, sometimes known as “ear pinning” is a procedure which aims to create a more natural appearance of the ear which does not draw attention. For older children and adults this can often be done as an in-office procedure.