Ear & Hearing
What is an Audiologist?,
An Audiologist is a professional who evaluates and treats people with hearing loss and balance disorders. Audiologists have extensive training (at least a Masters level degree) to evaluate infants to adults to determine the best intervention, whether it be medical or amplification.
What do Audiologists do?
Audiologists perform comprehensive audiological evaluations for people of all ages, counseling, evaluating for and fitting of hearing aids and other assistive listening devices, cochlear implant rehabilitation, hearing conservation, balance testing, brainstem testing, and newborn hearing screenings.
Why should I see an Audiologist?
Audiologists have a Masters or Doctoral degree from accredited universities with special training in the prevention, identification, assessment, and non-medical treatment of hearing and balance disorders.
What are Otoacoustic Emissions?
Otoacoustic Emissions (OAEs) are sounds generated within the cochlea of nearly all normal hearing ears by active biomechanical processes within the outer hair cells. OAEs are present in all normal ears, therefore it can be assumed that the absence is a sign of irregular cochlear function which could result in a hearing loss. Otoacoustics are used to screen infants and difficult to test patients to determine if a hearing loss is present.
How do I know if my child has a hearing loss?
Each child develops at his/her own pace. Below are some guidelines to your baby's hearing and speech development. Birth to 3 months: startles at sudden noise, recognizes your voice, and quiets when spoken to. 3 months to 6 months: turns towards interesting sounds and appears to listen, awakes easily to sounds. 6 months to 12 months: turns head towards soft sounds, understands no and bye-bye, begins to imitate speech sounds. 12 months + :says first words i.e. da-da, bye-bye, and ma-ma.
What are the high risk conditions associated with hearing loss in babies?
• Family member with permanent hearing loss since childhood.
• Serious infection present at birth (i.e. herpes, syphilis, German measles).
• Difficult birth or delivery which affected baby's breathing.
• Cranio-facial abnormalities (i.e. cleft palate, malformed ears).
• Baby requiring NICU for 2 or more days following birth.
• Disorder or infection of the brain (i.e. meningitis).
• Blood exchange or transfusion.
Hearing Protection
What is a noise induced hearing loss?
Typically individuals who are exposed to excessive noise demonstrate a high frequency hearing loss affecting the hearing nerve.
How loud is too loud?
Exposure to sounds over 85dB are dangerous to the auditory system. These sounds may be generated by: lawnmowers, shop tools, truck traffic, rock concerts, automobile horns, jet engines, and gunfire.
What type of hearing protection devices are best?
There are several over the counter hearing protection devices available at local pharmacies and sporting goods stores. Most available have a Noise Reduction Rating (NRR) of 15 to 30 dB listed on the package. This rating is valid only if the ear plugs are properly inserted and continuously worn. Earmuffs which fit over the entire outer ear create a seal around the ear keeping the harmful effects of noise out. Earplugs and earmuffs may be used in conjunction with each other in instances of extreme noise (>105dB) and typically provide 10-15dB additional protection.
Nose & Sinus
What is sinusitis?
Sinusitis is inflammation of the sinuses caused by infections (bacterial, viral, or fungal) and/or allergies. Acute sinusitis is very common and usually lasts less then 2 weeks, where chronic sinusitis can last months and is much more difficult to treat.
What are nasal polyps?
Nasal polyps are grape-like outpouchings from the nasal sinus linings that are usually indicative of an allergic component to the sinus disease. They often obstruct the normal sinus drainage and airflow creating more congestion, infections and decreased sense of smell.
How is sinusitis treated?
In general, the treatment of sinusitis depends on the duration and severity of the symptoms. Most often multiple medications such as an antibiotic(fights bacterial infections), decongestant (allows drainage), mucolytic (thins mucus), corticosteroid (reduces inflammation), and nasal irrigation are prescribed. There are many appropriate medications in each of these categories and the best treatment plan must be individualized. Infrequently, sinus surgery is needed for acute uncomplicated sinusitis.
When is a CT scan needed in the evaluation of sinusitis?
CT scans are very helpful in patients with chronic refractory sinusitis, complications of sinusitis and suspected malignancy. In addition, it is helpful for the evaluation of anatomy prior to sinus surgery.
When is surgery useful for sinusitis?
Surgery is most beneficial in symptomatic patients with mechanical obstruction to sinus drainage and those with persistent infections that have failed medical therapy. More urgent sinus surgery may be indicated when the eye or brain (which surround the sinuses) are affected by the sinus disease.
Does sinus surgery always work?
When the above indications are met, sinus surgery usually has a dramatic impact on the patients’ symptoms. The patient may still require medication and irrigation to prevent further inflammation and the re-development of sinus obstruction. In the unusual case where the symptoms are not relieved or they recur quickly, the ENT surgeon may investigate other causes such as allergy or Immune-system problems that may be underlying these refractory cases.
Throat & Neck
What are the functions of the tonsils and adenoids?
Tonsils and adenoids are near the entrance to the breathing passages where they can catch incoming germs, which cause infections. They sample bacteria and viruses and can become infected themselves. Scientists believe they work as part of the body’s immune system by filtering germs that attempt to invade the body, an that they help develop antibodies to germs. This happens primarily during the first few years of life, becoming less important as we get older. Children who must have their tonsils and adenoids removed suffer no loss in their resistance.
Is it recommended to remove tonsils and adenoids?
Tonsillectomy (removal of tonsils) is recommended for people who experience frequent throat infections. Adenoideciomy (removal of adenoids) are recommended for recurrent ear or nasal infections. Other reasons to remove tonsils and adenoids is if they are enlarged, as this can cause obstructive symptoms, such as sleep apnea, swallowing difficulties, nasal sounding speech, dental malocclusion and even heart failure. Recent reports also link enlarged tonsils and adenoids to obstructive breathing and sleep apnea, which can cause poor concentration and irritability during the day. This can be confused with ADHD. These patients often improve significantly after removal of their tonsils and adenoids. This procedure rarely requires hospitalization and can be safely done in our surgery center.
When should tonsils/adenoids be removed?
The two most common reasons for removal of tonsils and adenoids are recurrent infection despite antibiotic therapy, and difficulty breathing due to enlarged tonsils and /or adenoids. Some orthodontists believe chronic mouth breathing from large tonsils causes malformations of the face and poor teeth alignment. Adenoids are very close to the Eustachian tube and when infected or enlarged can contribute to ear disease. Much more rarely tonsils are removed to check for the possibility of cancer in patients with very asymmetric tonsils or others signs of malignancy.
How is sleep apnea diagnosed?
The patients symptoms and physical examination often point to the diagnosis and then a sleep study (polysomnogram) is performed to confirm the diagnosis and to provide more details on the severity of the sleep apnea, which will then help in deciding the best treatment.
Is there any solution for my snoring?
Snoring is a very common problem which results from the disturbance of air flow. Vibration of the uvula and soft palate creates most of the unpleasant noise. Treatment centers around stiffening and/or removal of these structures. Before treatment is applied, it is very important to rule out sleep apnea, a condition in which snorers stop breathing while asleep. Sleep apnea is a serious condition that may lead to heart, lung or brain problems. Treatment options to reduce snoring include: 1) Injection Snoreplasty; injection into the soft palate leads to subsequent stiffening; 2) Somnoplasty: Radiofrequency stiffening treatments of the soft palate; 3) Radiofrequency Turbinate Reduction; shrinks nasal tissue that may also contribute to sound production; 4) Other procedures that involve tissue removal (uvula, palate, and/or tonsils). Many of these newer procedures can be performed in our office with minimal discomfort.