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Ear, Nose & Throat Associates |
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ENT Otology Services
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EAR INFECTION
Infections can affect different parts of the ear. Otitis externa, also known as swimmer’s ear, is a bacterial or fungal infection of the ear canal. Often this type of infection occurs as a result of a combination of irritation of the ear canal skin and water exposure of the ear. Using cotton swabs or placing other foreign objects in the ear canals are common contributors, as these cause trauma to the delicate ear canal skin and impact wax deep into the ear canal. Someone with otitis externa may experience ear pain, drainage and blockage of his or her hearing. An otolaryngologist must often clear the debris from the ear canal for resolution of the infection. Treatment may also include prescription ear drops or powders, and keeping water and cotton swabs out of the ear canal is critical.
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Acute otitis media is an infection of the middle ear, which is the normally aerated portion of the ear behind the eardrum. Eustachian tube dysfunction, or inadequate functioning of the tube extending from the back of the nose to the middle ear, is a common contributor to the development of middle ear infection. Illnesses which obstruct the eustachian tube include viral or bacterial upper respiratory infections, sinusitis or allergies. Otitis media is more common in children, but may also occur in adults. Symptoms may include earache, fever or dizziness. A child may be fussy or pull on his or her ears. Treatment initially may include antibiotics and decongestants. With frequent recurrence of these infections, placement of myringotomy tubes, also known as ventilation tubes, pressure equalization tubes, or "ear tubes," is sometimes necessary. Another common reason for the placement of such tubes includes an extended bout of serous otitis media, (also known as a middle ear effusion) which is the retention of non-infected fluid behind the eardrum. Such fluid can lead to hearing loss, delays in speech development or imbalance.
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Additional information:
Ear Ache (American Academy of Otolaryngology - Head and Neck Surgery)
Swimmers' Ear (AAO - HNS)
Ear Tubes (AAO - HNS)
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EAR WAX
Cerumen, or ear wax, is a normal part of the ear canal. It serves to moisturize the skin and prevent infections. Cerumen impaction in the ear canals may result from use of cotton swabs, which pushes the wax deep into the ear canal. Other people are prone to wax impaction due to small ear canals or excessive wax production. If not able to be removed by a primary care physician, the wax can be removed by an otolaryngologist, who has special instruments, microscopes and suction equipment.
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Additional information:
Ear Wax (AAO - HNS)
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 PERFORATED EAR DRUM
People can develop a perforation in the eardrum for a variety of reasons. These include chronic ear infections or trauma to the ear, such as from a blow to the head or from injuring the eardrum with an object such as a cotton swab. Water entering the middle ear space through a perforation may result in infection, pain and drainage. More sizeable holes can also lead to hearing loss. Some perforations close without treatment, but in other cases surgical procedures are necessary. Repair of perforations may be performed by an otolaryngologist in the office using paper patches or other techniques to repair the eardrum. If these are not successful a tympanoplasty, or a more extensive surgical repair of the eardrum, may need to be performed in the operating room.
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Additional information:
Perforated Ear Drum (AAO - HNS)
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CHOLESTEATOMA
A cholesteatoma is an abnormal collection of skin behind the eardrum. Often this results from chronic eustachian tube dysfunction, but more rarely may be present at birth. Though not a tumor, a cholesteatoma may cause destruction of the normal ear structures, including the eardrum, or the middle ear bones. These bones, also known as ossicles, include the malleus, incus and stapes. More rarely, cholesteatomas may cause injury to the facial nerve, disrupt the balance system, or lead to meningitis. It is important that cholesteatomas be evaluated by an otolaryngologist in a timely manner. Most often tympanomastoidectomy ear surgery is required for removal. Physicians in the Ear, Nose and Throat Associates of San Mateo practice perform these surgeries regularly. They are performed using NIM (Nerve Integrity Monitoring) to help protect of the facial nerve during surgery.
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Additional information:
Cholesteatoma (AAO - HNS)
Medtronic NIM Monitor
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TINNITUS
Tinnitus is a word to describe any of a variety of noises in the ears. These can range from ringing, buzzing, or roaring to clicking or pulsing. This condition is very common, and can be transient or continuous. It can be associated with a variety of conditions including hearing loss, allergies, noise exposure, thyroid conditions, blood pressure issues, diabetes and use of various medications such as aspirin, ibuprofen, naprosyn, and certain blood pressure medications or antibiotics. It is important that a person with tinnitus undergo both a complete physical examination by his or her primary care physician, as well as a full evaluation by an otolaryngologist. Audiologic evaluation is frequently performed.
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Additional information:
Tinnitus (AAO - HNS)
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HEARING LOSS
Hearing loss falls into two broad categories, conductive and sensorineural. An otolaryngologist, together with an audiologist, can help determine which type of hearing loss is present. Physicians at the Ear, Nose and Throat Associates of San Mateo County work together with the audiologists of the Hearing Resource Center of San Mateo, who provide complete audiologic evaluations of patients.
 Conductive hearing losses include loss of hearing due to physical blockages or problems with the sound conduction structures of the ear. Examples include perforated eardrums, ear infections, cholesteatomas or impacted ear wax. Otosclerosis is an ear disease which often leads to fixation of the middle ear bones (or ossicles), which inhibits their proper vibration. Exostoses are bony outgrowths of the ear canal which may also block hearing. These occur more often in people who surf or have had a history of cold water exposure to the ears, and can be removed surgically.
Sensorineural hearing losses refer to problems hearing related to the inner ear, including the cochlea, as well as the nerve of hearing. Such hearing losses may occur due to hereditary factors, noise exposure, certain drugs or trauma. Sensorineural hearing loss can also result from certain inner ear diseases such as Meniere's disease or autoimmune hearing losses. Though many sensorineural hearing losses occur gradually, they may also occur suddenly. Any sudden hearing loss should be promptly evaluated by an otolaryngologist, as treatment needs to be started immediately.
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Additional information:
How the Ear Works (AAO - HNS)
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HEARING AIDS
Hearing aids may be necessary for people with sensorineural hearing losses, or sometimes for those with conductive hearing losses, if the latter are not surgically correctable. The Hearing Resource Center of San Mateo, is staffed with professional audiologists. They carefully evaluate each patient's hearing loss and make recommendations for hearing aids that are most appropriate for that individual.
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Additional information:
How the Ear Works (AAO - HNS)
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FACIAL NERVE PARALYSIS
The facial nerve, or the nerve which leads to movement of the muscles of the face, can cease to function for a variety of reasons. Paralysis can result from trauma, severe ear infections, or from certain tumors. If a specific cause cannot be found, often the term used to describe the facial nerve weakness is Bell's Palsy. Inflammation of the nerve in this case is often thought to result from a viral infection. It is important that the various potential causes of facial nerve paralysis be examined and treated promptly.
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Additional information:
Bell's Palsy (AAO - HNS)
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DIZZINESS
Dizziness is a general term which can imply imbalance, lightheadedness, or vertigo, which is a sense of motion when no actual motion is present. The balance system is quite complicated, relying on the eyes, inner ears, pressure sensors in the feet and brain to coordinate appropriately. As such, it is important that every patient with dizziness undergo complete evaluation by his or her primary care physician. Lightheadedness may relate to blood pressure, blood sugar, use of certain medications, or a variety of other causes. Vertigo is more often related to the inner ear, but may also relate to migraine headaches, strokes and other central nervous system conditions. Viral illnesses of the inner ear or trauma may also lead to vertigo, as can certain inner ear diseases such as Meniere's disease. A common reason for vertigo includes BPPV, or benign paroxysmal positioning vertigo, which relates to benign calcifications that have become dislodged in the inner ear. The otolaryngologist can help clarify to what the vertigo may be related, and can recommend specific treatments for each cause. Audiologic evaluation is an important part of the evaluation.
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Additional information:
Dizziness and Motion Sickness (AAO - HNS)
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100 South Ellsworth Avenue, Suite 308, San Mateo CA 94401
tel 650/344 6896 fax 650/344 2794
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805 Veterans Boulevard, Suite 115, Redwood City CA 94063
tel 650/369 1619 fax 650/474 2997
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