Hearing Aids:

Hearing loss can be improved with hearing aids in nearly all cases (see next section on hearing aids). Most hearing aids are programmed to amplify each frequency a different amount, based on the amount of your hearing loss at that particular frequency, improving your ability to hear and understand speech more clearly. The addition of directional microphones, improves your ability to hear in background noise. Hearing aids not only help for hearing loss but often are helpful for those with ringing in the ears (tinnitus)

Assistive Listening Devices:

There are a variety of devices that can help with your hearing, other than hearing aids. Advanced ENT offers innovative products for the hearing impaired. We offer a full line of assistive listening devices, such as amplified telephones and television volume assistance devices called "TV Ears". TV Ears attach to the back of your television and transmit the sound to a wireless headset (ear phones) that you wear. You have your own volume control on the headset so that you can listen to the television at a volume that is different than the others in the room. TV Ears come with either one or two headsets.

Ear Plugs:

Prevention of further hearing loss is very important. We fit a variety of ear plugs for those exposed to loud sounds as well as custom plugs made for musicians (musician’s plugs.) Musician’s plugs preserve the fidelity of music as well as protecting hearing from excessive sound levels. Musicians may also be fitted for in the ear monitors that allow the musician to hear their own music while protecting their ears from other loud sounds. Custom swim plugs are also made to protect the ears from water exposure. The swim plugs are used for those with a hole in the ear drum, tubes in the ears or to prevent recurrent outer ear infections.

Medications:

Medications may be a treatment option for certain ear diseases. Infections are typically treated with medications. Ear infections may affect the outer ear, middle ear, or inner ear. The following are conditions that are primarily treated with medications.

Outer ear infections (Otitis Externa): An infection of the outer ear canal is most commonly referred to as "swimmer's ear." The infection is found in the outer ear canal. The most common cause of an outer ear infection is bacteria that enters the ear canal when you swim. When poor or lake water gets in your ear, it usually runs back out and everything is fine. Sometimes, however, this water may get trapped in the ear canal. Since water is rarely sterile, the bacteria or fungi that entered the ear canal can cause an infection. Regular use of Q tip cotton swabs may also irritate the ear canal and lead to an outer ear infection. Symptoms include pain, itching, fullness, loss of hearing, and a discharge from the ear canal.

An outer ear infection is treated with an antibiotic ear drop, a thorough cleaning of the drainage and wax in the ear canal, and sometimes antibiotics taken by mouth. If drainage re-accumulates, the ear may have to be cleaned out several times a week until the infection is gone. If the ear canal is too swollen, we may also put in a wick device to allow the antibiotic drops get down to the bottom of the ear canal.

To prevent outer ear infections in swimmers, custom ear plugs can be made that completely seal the ear canal from water. These custom ear plugs are fit in our office and are recommended for anyone who swims regularly or has had swimmer's ear in the past.

Middle ear infections (Otitis Media): Middle ear infections are common forms of ear infections that affect children in much greater numbers than adults. Middle ear infections are infections that occur behind the eardrum and are typically caused by viruses or bacteria related to colds or allergies. One or both ears may be involved.

• Acute middle ear infections
  The Eustachian tube connects your middle ear with the back of your nose. Normally, the Eustachian tube drains fluid from the ear into the nose and also equalizes the air pressure on each side of the eardrum when you swallow. When you have a cold, however, bacteria can enter the tube, irritating it and causing it to swell. This swelling blocks the drainage from the ear and causes a buildup of pressure from both fluid and air that are trapped in the middle ear. If infection from the Eustachian tube spreads to the fluid in the middle ear, pressure will increase behind the eardrum and cause pain. It is also possible for the eardrum to rupture.
  
  In young children and infants, the Eustachian tube is shorter and straighter than in adults. This causes more frequent infections because it is easier for the germs and bacteria to reach the middle ear. Acute middle ear infections are treated with antibiotics and sometimes decongestants or steroids. Recurrent acute middle ear infections are typically treated by Myringotomy with tubes (see surgical treatments)
  
  
• Chronic middle ear infections
  If the fluid isn't drained either through a rupture of the eardrum or relief of swelling of the Eustachian tube, the infection can become "chronic" meaning that it is an ongoing condition. The fluid that is trapped in the middle ear will become thicker, which reduces its volume and relieves the pressure. Rather than being forced outward, the eardrum will now be pulled inward due to the change in pressure. This stiffens the eardrum and reduces hearing.

Allergies and enlarged adenoids may also contribute to chronic ear infections. Adenoids are tissues at the back of the nose that help the body build resistance to infections. In young children (typically under the age of five), the adenoids can swell from repeated infections, blocking the Eustachian tube and preventing fluid from draining from the middle ear. It is also possible for some of the bacteria on the adenoids to enter the Eustachian tube and spread to the middle ear.

Chronic ear infections in children can lead to delayed speech due long standing hearing loss. For chronic ear infections that do not improve or respond to antibiotics, your physician may recommend a procedure called Myringotomy with tubes (see surgical treatments).

Prevention of middle ear infections

• Increase handwashing to prevent spreading germs
• If nasal allergies are a problem, avoid as many of the allergens as possible.
• Food allergies can cause swelling of the Eustachian tube. Avoid these foods.
• In children, avoid contact with other sick children, such as being in day care.
• Avoid 2nd hand smoke exposure

Inner ear infections (Otitis Interna): Inner ear infections that affect the cochlea, result in hearing problems, such as ringing in the ears (tinnitus) or hearing loss. Infections that affect the vestibular system result in dizziness.

Inner ear infections (otitis interna) or labyrinthitis, are almost always caused by viruses, but can also happen as a complication of a middle ear infection. When the inner ear is infected, the inner ear cochlea nerves are affected often leading to permanent hearing loss. When the balance part of the inner ear is affected, it leads to vertigo, which can cause a spinning sensation, nausea, and vomiting.

Inner ear infections are typically treated with medications to reduce the symptoms: anti-nausea medicine, anti-vertigo medication, and occasionally antiviral medications or steroids.

Meniere's Disease: Meniere’s disease is also treated with medication. Meniere’s disease is due to an excess amount of fluid in the inner ear that results in:

• Episodes of vertigo or dizziness (spinning sensations), and sometimes nausea
• Progressive, low-frequency hearing loss
• Tinnitus (ringing in the ears)
• A feeling of pressure in the ear

Also known as endolymphatic hydrops, Meniere's disease is a common cause of dizziness. The disease typically affects people ages 20 through 50 and can occur in one or both ears. Dizziness episodes can last from 20 minutes up to two hours, however the feeling of being off balance can last for days. Changes in hearing can fluctuate, as can the tinnitus and other symptoms.

Medications and lifestyle changes can help control Meniere's disease. Medications include diuretics (water pills) to eliminate excess fluid and prevent dizziness, anti-vertigo drugs and anti-nausea drugs. Dietary and lifestyle changes are also helpful, including lowering your intake of salt, avoiding caffeine, alcohol and smoking. Living a healthy lifestyle and controlling stress can also be very helpful in controlling Meniere's.

Tinnitus Masker:

Ringing in the ears (tinnitus) can be improved with hearing aids if there is an underlying hearing loss or with a tinnitus masker device if the hearing is normal. The tinnitus masker is similar in appearance to a hearing aid and is worn in the ear canal. The masker creates a white noise, which can be turned on and off or adjusted by you. The white noise typically reduces or eliminates the ringing sound and is effective while wearing the masker and for several hours after taking it off.

Other Treatments for Tinnitus:

Many people complain that their tinnitus is worse when it is quiet, such as when first coming home or just before bed. One of the best ways to avoid the stress of tinnitus is to never be in a room that is completely quiet. Always have some background noise present such as a fan or radio/TV playing in the background at low volume. You may also purchase a sound machine that plays a monotonous sound like water flowing, wind blowing, or leaves rustling.

Tinnitus that has no apparent cause can be extremely stressful for some people. For others, simply knowing that there is no serious underlying problem allows them to better handle tinnitus and learn to deal with it on their own. The key, however, is to try to ignore Tinnitus and focus on other things. Your body can often learn to adjust to it and move it to the "background." For those whose coping skills can't effectively handle the stress of tinnitus, there are some other therapies that can often be helpful.

Biofeedback is a way to learn about your body and how to control certain processes within your body such as stress. By controlling how your body responds to stress, you may be able to also lessen your response to tinnitus. Going hand in hand with biofeedback and controlling reactions is cognitive therapy. Cognitive therapy treats your reaction to tinnitus rather than the tinnitus itself. The goal is to identify negative behaviors associated with tinnitus and come up with alternative behaviors. For more information, visit the American Tinnitus Association.