More than 48 million Americans have some degree of hearing loss. There are three major types of hearing loss, but every individual’s experience is affected by different factors, such as genetics, age and exposure to noise.

The three types of hearing loss are conductive, sensorineural and mixed. Conductive hearing loss is maybe due to problems with the ear canal, eardrum or middle ear that prevent sound from passing through the ear. Sensorineural hearing loss is maybe caused by problems with the inner ear (the cochlea) or the nerves coming from the cochlea, which senses sound waves and sends them to the brain for processing. Mixed hearing loss is a combination of both conductive and sensorineural. Our clinicians will determine what type of hearing loss you are experiencing and develop an effective and specialized treatment plan for your unique hearing needs.

Symptoms of hearing loss can go unnoticed if you don’t know what to look for. A very common symptom is difficulty hearing in noisy settings such as at a restaurant or party. Other symptoms include frequently asking people to repeat themselves, ringing in the ears, turning up the TV or radio volume louder than others need it and withdrawing from conversations. In children, symptoms of hearing loss may include not responding to noises, speaking unclearly and not following simple commands.

If you experience sudden deafness due to a loud noise or any other reason, you should seek immediate medical attention. While most hearing loss is gradual, one can have a sudden hearing loss. This can be an emergency.

Please contact us at (479) 750-2080 to schedule an appointment if you or someone you know is experiencing symptoms of hearing loss.

Age-Associated Hearing Loss
Roughly one in three people between ages 65 and 74 in the United States has hearing loss. This number is even greater for those over 75 – nearly one in two. Age-associated hearing loss, also called presbycusis, is one of the most common conditions in aging seniors.

Noise-Induced Hearing Loss
Noise-induced hearing loss is one of the most common causes of hearing loss. It is the permanent hearing impairment that results from prolonged exposure to loud noises or a single exposure to an especially loud noise such as an explosion. Those who are most likely to suffer from noise-induced hearing loss are people who work in noisy environments such as construction sites, airports, concert venues or military bases.

Sudden Hearing Loss
Sudden hearing loss is considered a medical emergency – those who experience this phenomenon should contact their doctors immediately. It usually occurs just in one ear either at once or over several days. Causes may include infection, trauma, ototoxic drugs, a tumor or blood circulation problems. Sudden hearing loss is diagnosed by an audiogram (hearing test.)

Ear surgery is performed to treat diseases, injuries and deformations of the ear. There are many types of ear surgeries because there are many problems that can affect the ear.

Common ear surgeries include stapedotomy to treat hearing loss, myringoplasty or tympanoplasty to reconstruct damaged eardrums, mastoidectomy to eliminate disease or infection, ear tube surgery, cochlear implant surgery, tumor removal, and surgery for congenital ear defects. Laser surgery for the middle ear is becoming increasingly popular because it reduces the amount of trauma to the ear.

Ear Tubes

Ear tubes are a common treatment for chronic or recurrent ear infections, which are most prevalent in young children, but also occur in teens and adults. Ear tubes are small cylinders that are surgically implanted within the eardrums to allow air and fluid to flow to and from the middle ear. Ear tubes can either be a short term treatment (six months to a year) that fall out on their own or a long-term treatment that requires removal at the doctor’s discretion.

Otoplasty

Otoplasty is a plastic surgery procedure that corrects deformities and defects of the external ear. Sometimes this involves reconstructing defective, or even absent, features of the ear due to birth defects or trauma. Another version is correction of protruding ears for cosmetic purposes. For more information, visit www.ozarkfacialplastics.com.

Perforated Eardrum

A perforated eardrum, sometimes called a ruptured eardrum, may happen when the thin membrane between the ear canal and the middle ear is punctured by a foreign object or blown out by a loud noise. It can also be caused by infection or head trauma. A perforated eardrum can be very painful and may cause hearing loss. If the perforation is very small, it can heal on its own over time. However, a patch or even surgery may be required to reclose a severely perforated eardrum.

Stapedotomy

A stapedotomy is a surgery of the stapes bone in the middle ear. The stapes bone can become stuck and therefore not transfer sound waves traveling toward the inner ear, which results in hearing loss. The purpose of the surgery is to bypass the top of the stapes bone and allow sound waves to travel all the way to the inner ear.

If you are suffering from vertigo or dizzy spells, consider the following questions:

1. Do you experience any of the following symptoms of dizziness?

• Lightheadedness
• Tendency to fall or lose balance
• Sensation of spinning
• Headache
• Nausea with motion
• Vomiting

2. Do you suffer from any of the following hearing conditions?

• Hearing loss
• Tinnitus (ringing in the ears)
• Pressure in the ears
• Pain in the ears
• Discharge from the ears

If you answered “yes” to either of these questions, contact us at (479) 750-2080 to meet with one of our ENT specialists and have your balance evaluated.

Vestibular neuronitis is disease of the vestibular nerve that causes severe episodes of vertigo. The vestibular nerve is responsible for sending messages from the inner ear to the brain. If the vestibular nerves in each ear are sending different signals, the result is an inability to feel balanced. Vestibular neuronitis is most common in adults.

Symptoms can vary from mild dizzy spells to a severe swaying sensation. Other symptoms include nausea, vomiting, trouble seeing and impaired concentration. These symptoms typically occur suddenly and without warning, and they can even keep someone from being able to stand or walk. Vestibular neurosis can cause severe symptoms that last up to several days and mild symptoms that can occur for several weeks. If there is permanent damage to the vestibular nerve, however, the person may develop chronic symptoms.

To diagnose vestibular neuronitis, the doctor will first rule out other causes of vertigo symptoms such as stroke, allergies, side effects of drugs or neurological disorders. The doctor will then assess rapid eye movements, as this can be caused by issues with the vestibular system. The doctor may also conduct hearing tests, balance tests and focus tests.

In most cases, vestibular neuronitis is caused by a viral infection, which can be systemic (whole body) or confined to the ear. Some viral infections associated with vestibular neuronitis include herpes, measles, mononucleosis, influenza, mumps and hepatitis. If this is the case, the doctor will treat the underlying cause with antibiotics. If this doesn’t work, the doctor will prescribe medications to manage nausea, dizziness and other bothersome symptoms.

Meniere’s disease is a disorder that attacks the inner ear and causes symptoms of vertigo (dizzy spells and nausea), hearing loss, tinnitus (ringing in the ears) and a plugged or pressurized feeling in the ears. Symptoms can last between twenty minutes and four hours. If left untreated, Meniere’s disease can cause permanent hearing loss. It generally affects people between the ages of 20 and 50.

Many believe Meniere’s can result from an abnormal volume of fluid in the inner ear when excess production or inadequate absorption occurs. Allergies or autoimmune disorders may also cause Meniere’s disease. Those with Meniere’s disease are more prone to experiencing fatigue and stress.

In order to diagnose the disease, your doctor will ask you about your history including frequency, duration and severity of symptoms. Then diagnostic tests will be performed. Hearing tests such as speech discrimination evaluations can determine if the affected ear is experiencing temporary or permanent hearing loss. Balance tests such as ENT or VNG may be performed to determine if the balance system is affected by the disease. Other tests can determine if fluid pressure or auditory brain stem response is abnormal. If these tests are positive, the patient likely has Meniere’s disease.

Although there is no sure cure for Meniere’s disease, some behaviors can help reduce symptoms. Your doctor may recommend a low salt diet and a diuretic, anti-vertigo medications, intratympanic injection of medications, air pressure pulse generator and/or surgery. Surgery is only recommended if vertigo attacks are not managed by alternative treatments or if the symptoms are disabling.

The Epley maneuver is a series of head movements that restores equilibrium of the vestibular system and relieves symptoms of benign positional vertigo (BPV). BPV is caused by disturbances of the vestibular system in the inner ear when crystals of calcium carbonate clog the semicircular canals and sensory receptors send mixed signals to the brain about the body’s position. There are four major steps that make up the Epley maneuver.

For the first step, you will sit on an exam table with your legs extended. The doctor will turn your head 45 degrees in the direction of the affected ear that is causing BPV. Keeping your head in place, the doctor will tell you to lie back until your shoulders are resting on the table. Your head, however, will hang over the edge with the affected ear facing the floor. You will remain in this position for 30 seconds or until symptoms of BPV cease.

Second, without changing your elevation, the doctor will turn your head to a 45-degree angle in the opposite direction so that your affected ear faces the ceiling. On this side, the doctor will hold your head for 30 seconds or until BPV symptoms stop.

Third, the doctor will hold your head still and you will roll your body so that you are lying on your side, in the same direction your head is facing. At this point, the affected ear that is causing your BPV is still facing upward. Again, you will remain in this position for 30 seconds or until BPV stops.

Finally, you will slowly sit up and hang your legs off the table, in the same direction you were facing when lying down.

The whole session takes about ten to fifteen minutes. If it is successful, the crystals will become dislodged from the semicircular canals and you will no longer experience BPV symptoms.

The most common form of vertigo is benign positional vertigo (BPV). BPV is a sensation similar to spinning and can be triggered by tilting your head up or down, turning over, lying down or getting up. If you have BPV, you may experience brief episodes of dizziness.

BPV is caused by disturbances of the vestibular system in the inner ear. Within the vestibular system are semicircular canals that contain fluid. The fluid moves against sensory receptors that tell your brain when your head is making rotational movements. BPV occurs when crystals of calcium carbonate clog the semicircular canals because the vestibular system then sends mixed messages to the brain about the body’s position.

Although the most common symptom of BPV is dizziness or a “spinning” sensation, other symptoms include vomiting, blurred vision, nausea, lightheadedness and loss of balance. Generally, symptoms last less than a minute, but sometimes the symptoms can come and go. Abnormal eye movements called nystagmus can also accompany BPV.

BPV is diagnosed by a test called the Dix-Hallpike maneuver in which your head is held in a certain position while you lie down quickly. Eye movements are monitored and you are asked to describe your symptoms. The doctor may also complete a physical exam and collect a medical history.

There are several treatment options for BPV. One option is called the Epley maneuver, which is often said to be the most effective treatment option. The Epley maneuver involves moving in a way that dislodges the calcium carbonate crystals from the inner ear. Certain medications may also be used to relieve the sensation of spinning such as sedative-hypnotics, anticholinergics and antihistamines. Home treatments such as sitting down when you feel dizzy, avoiding triggering behaviors and being aware of your surroundings can help prevent injury.

The vestibular system is the sensory system that contributes to our sense of balance and spatial orientation. The system is located in the inner ear and consists of the semicircular canals, the utricle, the saccule, the cupula, ampullae and the cochlea. The vestibular system sends signals to both the nerves in the eyes and the muscles that keep a person upright to maintain a sense of balance.

The system as a whole detects motion, equilibrium and special orientation of the body using the systems of the semicircular canals, utricle and saccule. The utricle and saccule detect the vertical orientation (gravitational pull) of the body and other linear movements. There is one utricle and one saccule in each ear, both located near the center of the vestibular system.

There are three semicircular canals: the anterior canal, the lateral canal and the posterior canal. These canals work together to detect rotational movements. They are located at right angles to each other and are filled with endolymph, a fluid which exerts pressure against the canals’ sensory receptors. When the sensors are triggered, they send impulses to the brain that movement has been detected from whichever canal is stimulated.

When a vestibular system is properly functioning, the vestibular organs on each side of the head send the same impulses to the brain. If they send signals that are inconsistent, a person can feel off-balance or disjointed. If disease attacks the vestibular system or if it is for any reason malfunctioning, the most common symptom is vertigo, which presents as instability and nausea.

The vestibular system in the inner ear is the primary sensory system when it comes to balance. If this system malfunctions, the patient will likely experience balance problems such as vertigo. When this happens, an audiologist can test the vestibular system using videonystamography (VNG) or electronystagmography (ENG) methods. These tests can determine the health of the balance system and which ear may be affected.

With VNG, goggles are placed over the eyes with wires that connect them to a computer. The goggles contain a camera that monitors eye movement. With ENG, electrodes placed beside each eye also monitor eye movements and send results to a computer. The computer analyzes the eye movements and the results are interpreted by an audiologist to determine if problems are present with the vestibular system.

There are three parts to the test. First, the patient sits up in a chair and watches moving lights. The purpose of this is to assess the visual system. Second, the patient lies back and moves their eyes while in various head and body positions. This assesses the effect changing orientation has on the patient. Third, the patient lies back at an angle. Short bursts of warm and cool air are blown into the patient’s ear. The purpose of this is to assess the balance system.

The purpose of VNG and ENG is to test the vestibulo-ocular reflex. This system in the eye and inner ear generates eye movements that maintain steady vision when the body, particularly the head, is moving. VNG and ENG can detect if there is a disconnect between the ocular and visual systems.

The most common form of vertigo is benign positional vertigo (BPV). BPV is a sensation similar to spinning and can be triggered by tilting your head up or down, turning over, lying down or getting up. If you have BPV, you may experience brief episodes of dizziness.

BPV is caused by disturbances of the vestibular system in the inner ear. Within the vestibular system are semicircular canals that contain fluid. The fluid moves against sensory receptors that tell your brain when your head is making rotational movements. BPV occurs when crystals of calcium carbonate clog the semicircular canals because the vestibular system then sends mixed messages to the brain about the body’s position.

Although the most common symptom of BPV is dizziness or a “spinning” sensation, other symptoms include vomiting, blurred vision, nausea, lightheadedness and loss of balance. Generally, symptoms last less than a minute, but sometimes the symptoms can come and go. Abnormal eye movements called nystagmus can also accompany BPV.

BPV is diagnosed by a test called the Dix-Hallpike maneuver where your head is held in a certain position while you lie down quickly. Eye movements are monitored and you are asked to describe your symptoms. The doctor may also complete a physical exam and collect a medical history.

There are several treatment options for BPV. One option is called the Epley maneuver, which is often said to be the most effective treatment option. The Epley maneuver involves moving in a way that dislodges the calcium carbonate crystals from the inner ear. Certain medications may also be used to relieve the sensation of spinning such as sedative-hypnotics, anticholinergics and antihistamines. Home treatments such as sitting down when you feel dizzy, avoiding triggering behaviors and being aware of your surroundings can help prevent injury.