Outer Ear– includes external auricle, the ear canal, and up to the eardrum

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Ear Wax (cerumen):

Earwax is normal and wax that does not cause symptoms or block the ear canal should be left alone. Do not over clean your ears. Too much cleaning may bother your ear canal, cause infection, and may even increase your chances of earwax impaction. Never put cotton swabs, hair pins, car keys, toothpicks, or other things in your ear. These can all injure your ear. Do not use ear candles;

ear candles do not remove earwax and can cause serious damage to the canal and ear drum. Seek medical attention from your Sonoran ENTA specialist if you suspect that you have symptoms of hearing loss, ear fullness, or ear pain if you are not certain they are from earwax.

 

Outer ear infections (otitis externa):

Abrasions of the ear canal skin, excessive moisture, or excessive attempts at self ear cleaning may all lead to infection of the outer ear canal. Infections may be due to bacteria or possibly from fungus. Often patients seek care for this initially from other providers who do not have the ability to recognize the type of infection and therefore patients sometimes unnecessarily go days to weeks with ongoing infection without the proper treatment. Symptoms of ear pain, drainage, bleeding, hearing loss, or itchiness are best addressed by seeing a Sonoran ENTA specialist for prompt attention.

 

Piercings

Ear piercing is extremely common, with your lobes being the most pierced part of your ears. People of all ages get their ears pierced for different reasons. For some people, the choice to pierce is about fashion and expression, but for others, ear piercing is a matter of tradition. To avoid complications of piercing ears, it is important to use sterile technique to avoid risk of infection. At

Sonoran ENTA, ear piercings may be scheduled. We use sterile, medical-grade piercing equipment as well as a local anesthetic to make the piercing as painless as possible.

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Hole in the eardrum (tympanic membrane perforation):

Sometimes the eardrum can rupture, and if large enough or under certain conditions, may heal with a persistent hole. Causes can be from trauma, ear infections, or previous ear ventilation tube placement. While not in itself a dangerous condition, perforations may cause a significant hearing loss or allow for more frequent outer or middle ear infections. Here at Sonoran ENTA, we are well-equipped to diagnose and manage tympanic membrane perforations, and we can help counsel the patient whether surgical repair would be recommended.

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Middle ear – includes the space behind the eardrum.

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Middle ear infections (otitis media):

Middle ear infections are more common in younger children due to the anatomic orientation of the Eustachian tubes, and then become less common with older age. Most middle ear infections are uncomplicated and will resolve on their own or with a course of appropriate antibiotics. Symptoms include hearing loss, ear pain, and sometimes fever. Sometimes severe middle ear infections

would lead to tympanic membrane rupture and thus present with ear drainage. When patients get middle ear infections too frequently, placement of ear ventilation tubes may be recommended to prevent further episodes. For most adults this procedure can be safely performed in the office with use of topical anesthesia, whereas in children this is commonly done with a brief general anesthetic procedure performed at an outpatient surgery center or hospital.

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Eustachian Tube Disfunction

The natural ventilation tube that aerates the middle ear space and equalizes the pressure on either side of the ear drum is called the Eustachian tube. The opening of this tube is located at the back of the nasal passages on both sides. This is why sometimes with upper respiratory infections or allergy flareups, patient can have difficulties with unequal pressure development in the middle ear. With occasional episodes, this can be easily managed with oral or topical medications to decongest the Eustachian tube. With persistence, sometimes Eustachian tube dysfunction has to be managed with placement of a ventilation tube. More-recently, a procedure called Eustachian tube balloon dilation has emerged as a means to treat chronic obstruction without the need for ventilation tube placement. This is performed as an in-office procedure under local anesthesia.

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Inner ear – consists of the organs for hearing (cochlea) and balance (vestibular organ)

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Hearing Loss

Hearing loss comes in many forms. It can range from a mild loss, in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing.

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There are two general categories of hearing loss:

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• Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is usually permanent.

 

• Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may

be earwax buildup, fluid, or a punctured eardrum. Medical treatment or surgery may restore

conductive hearing loss.

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Hearing loss is a common problem caused by noise, aging, disease, and heredity. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

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Approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing. But some people may not want to admit they have trouble hearing. Older people who can’t hear well may become depressed, or they may withdraw from others because they feel frustrated or embarrassed about not understanding what is being said. Sometimes, older people are mistakenly thought to be confused, unresponsive, or uncooperative because they don’t hear well.

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Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, make an

appointment to see your Sonoran ENTA specialist. Hearing aids, special training, certain medicines, and

surgery are some of the treatments that can help.

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Tinnitus (Ringing in the ears)

Tinnitus is the perception of sound without an external source. It is estimated that over 30 million Americans have chronic tinnitus. Recent research provides insight to the mechanisms of tinnitus and the most effective treatments. At Sonoran ENTA we are always willing to address your symptoms of tinnitus and assist you toward successful treatment by providing you with the appropriate tools. It may be necessary for you to try more than one treatment approach, or a combination of approaches for success. We will never discount your symptoms nor make you feel helpless with your

symptoms of problematic tinnitus.

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Dizziness/Balance

Dizziness is a general term for many different symptoms. While it generally means an abnormal sensation of motion, it can also mean imbalance, lightheadedness, blacking out, staggering, disorientation, weakness and other sensations. Symptoms can range from mild and brief to severe spinning sensations accompanied by nausea also known as vertigo.

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Balance requires the interaction between many different organs and systems in the body. The brain is the central processing center for all balance information coming from the senses and for all information going out to the muscles of balance. Input comes from three main areas: vision, the balance portion of the inner ear, and the touch (from the feet and joints). Vision is an important cue to the brain which tells us if we are moving relative to our surroundings.

 

Dizziness can be caused by numerous disturbances to any of many different parts of the body. Based upon your history and physical findings your Sonoran ENTA provider may require further tests to complete a full evaluation. The tests necessary are determined at the time of examination and may include hearing and balance tests, imaging (CT or MRI scans), blood tests, and ultrasound tests. A general physical exam and neurological tests may also be needed.

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Many types of maladies occur in the inner ear to cause dizziness, including Meniere’s syndrome, labyrinthitis, positional vertigo, and vestibular neuritis, migraine and tumors of the inner ear nerves. These usually cause imbalance, vertigo (spinning), and nausea. It can also be accompanied by tinnitus and hearing loss, if the nearby cochlea is also affected. 

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A common test for dizziness is the videonystagmogram (VNG). In this test the strength of the inner ear is measured as well as the coordination of eye movements. They involve watching the eye movements after placing warm or cool air into the ear canal. This usually causes a normal sensation of brief dizziness. It is important not to be taking any medications which can affect the test such as Valium, Antivert, alcohol and others. When scheduling this test make sure to ask if your medications will impact the outcome of the tests.

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The object of this evaluation is to be certain that there is no serious or life-threatening disease and to try to pinpoint the exact site of the problem. This lays the groundwork for effective medical or surgical treatment.

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Diagnosis can often be difficult. Frequently multiple tests must be conducted. Patience and understanding is necessary on the part of the provider and patient alike.