Otology & Ear Surgery



Handouts

Baha®User Manuel
Baha® Single Sided Deafness Brochure
Baha®Pediatric Brochure
Ear Candles
Hearing & Balance Questionnaire Adult
Middle Ear Surgery After Care Instructions
Meniere's Disease

Otitis Media in Children
Otosclerosis Informed Consent
Services for Hearing Impaired Adults
Services for Hearing Impaired Children
Services for Speech Delayed Children
Tinnitus
Tympanostomy (English) Ear Tubes Pre-op
Tympanostomy (Spanish) Ear Tubes Pre-op

Ossicular Implants

The first titanium prosthesis was designed in 1994 in cooperation with doctors of the Dominikus Hospital in Dusseldorf. It was based on the years of experience Kurz had in designing and producing gold prostheses. Kurz followed the suggestions of well-known otologists, who introduced the idea of titanium as the material of the future in middle ear surgery. The superiority of the new implant compared to previous middle ear prostheses with respect to biocompatibility, hearing improvement and intraoperative manipulation became evident even in the testing phase. From a long-term perspective, the prosthesis has proven itself, especially in regard to its reliability and safety.

Benefits

  • Small mass for good sound conduction
  • Evenly distributed weight facilitates implantation
  • Large surface contact with the tympanic membrane or transplant prevents tilting
  • Optimal shape adaptability ensures smooth progress of the intervention
  • Excellent biocompatibility for irritant-free integration into the middle ear
  • Individual shape adaptation through simple bending
  • MR safe (7.0 T)

Baha® (Bone Anchored Hearing Aid) Implants

The Baha® system utilizes your body’s natural ability to conduct sound.

Bone, like air, can conduct sound vibrations. For people with hearing loss, this provides another pathway to perceive sound. Typical hearing aids rely on air conduction and a functioning middle ear.

In cases where the middle ear function is blocked, damaged or occluded, the Baha system may be a better option as it bypasses the outer and middle ear altogether. Instead, sound is sent around the damaged or problematic area, naturally stimulating the cochlea through bone conduction.

Once the cochlea receives these sound vibrations, the organ ‘hears’ in the same manner as through air conduction; the sound is converted into neural signals and is transferred to the brain, allowing a Baha recipient to perceive sound.

BAHA Surgery is indicated for single sided deafness.

>> Back to Pediatric ENT

Tympanostomy - Ear Tube Surgery

Ear tube insertion is the placement of tubes near a child’s eardrums. It is done to allow the fluid behind a child’s eardrums to drain so that the ears can function normally.

While the child is under general anesthesia (asleep and not able to feel pain), a small surgical cut is made in the eardrum. The built-up fluid is suctioned out through this cut. Then, a small tube is inserted through the eardrum. The tube allows air to flow in and fluid to constantly flow out of the middle ear.

Ear tube insertion may be recommended when fluid builds up behind your child's eardrum and does not go away after 4 months or longer. Fluid buildup may cause some hearing loss while it is present. But most children do not have long-term damage to their hearing or their ability to speak even when the fluid remains for many months.

An ear infection is another reason for inserting an ear tube. If an infection does not go away with the usual medical treatment, or if a child has many ear infections over a short period of time, the doctor may recommend ear tubes.

Ear tube insertion is also used sometimes for people of any age who have:

  • Barotrauma (pressure injury) from flying or deep sea diving
  • Hyperbaric oxygen therapy
  • A complication from a severe ear infection, such as mastoiditis, brain infection, meningitis, or facial nerve paralysis

Your child’s ear specialist may ask for a complete medical history and physical exam of your child before the procedure is done.

Always tell your child’s doctor or nurse:

  • What drugs your child is taking. Include drugs, herbs, and vitamins you bought without a prescription
  • What allergies your child may have to any medicines, latex, tape, or skin cleaner

On the day of the surgery:

  • Your child will usually be asked not to drink or eat anything after midnight the night before the surgery.

  • Give your child a small sip of water with any drugs your doctor told you to give your child.

  • Your child’s doctor or nurse will tell you when to arrive at the hospital.

  • The doctor will make sure your child is healthy enough for surgery. This means your child has no signs of illness or infection. If your child is ill, the surgery may be delayed.

Children usually stay in the recovery room for a short time and leave the hospital the same day the ear tubes are inserted. Your child may be groggy and irritable for an hour or so as they awaken from anesthesia. Your child’s doctor may prescribe ear drops or antibiotics for a few days after the surgery.

Most children can return to normal activities the day after the surgery.

Some ear specialists will recommend earplugs or swimmer’s headbands while swimming or bathing to keep water out of the ears. If earplugs are not recommended for these activities, they may be recommended for diving in deep water. Check with your ear specialist.

The surgical cut heals on its own, without stitches. The hole closes, and the ear tubes usually fall out on their own after 14 months or so.

After this procedure, most parents report their children have fewer ear infections, recover fast from infections, and that they worry less about whether their child has ear infections.

If the tubes do not fall out on their own, an ear specialist may have to remove them. If ear infections return after the tubes fall out, another set of ear tubes can be inserted.

Tympanoplasty - Ear Drum Repair

Eardrum repair, called tympanoplasty, is a procedure to correct a tear in the eardrum (tympanic membrane). Ossiculoplasty is the repair of the small bones in the middle ear.

Using general anesthesia, an ear-nose-throat (ENT) specialist grafts a small patch from a vein or fascia (muscle sheath) onto the eardrum to repair the tear.

For problems with the small bones (ossicles), the surgeon will use an operating microscope to view and repair this chain of small bones using plastic artificial bones or ossicles from a donor.

A number of problems can permanently damage your eardrum (tympanic membrane) or harm the very small bones (ossicles) that are right behind the eardrum. These problems include chronic ear infections, trauma, cancer, and cholesteatoma.

This damage may cause hearing loss, pain, or an infection that does not go away.

If antibiotics or other treatments do not heal chronic ear infections, then surgical eardrum repair may be necessary.

Always tell your doctor or nurse:

  • What allergies you may have to any medications, latex, tape, or skin cleanser
  • What drugs you are taking, including herbs, herbs, and vitamins you bought without a prescription

On the day of the surgery:

  • Take only a small sip of water with any drugs your doctor has prescribed
  • Tell your doctor if you have signs of illness or infection
  • You will usually be asked not to drink or eat anything after midnight the night before surgery
  • Your doctor or nurse will tell you when to arrive at the hospital

Patients usually leave the hospital the same day as the surgery. It is important to avoid water in the ear. There are sometimes stitches behind the ear for the first week and packing material in the ear. Your health care provider may recommend the use of a hair cap when showering for a few weeks after the procedure.

In most cases, the operation relieves pain and infection symptoms completely. Hearing loss is minor. The outcome may not be as good if the bones in the middle ear need reconstruction along with the eardrum.

Stapedectomy for Otosclerosis

Otosclerosis is an abnormal bone growth in the middle ear that causes hearing loss.

Causes

The cause of otosclerosis is unknown, but there appears to be a heriditary component, meaning it can be passed down through families. In this condition, an abnormal sponge-like bone grows in the middle ear. This growth prevents the ear from vibrating in response to sound waves -- which must happen in order for you to hear. This lack of vibration leads to hearing loss that continues to get worse with time.

Otosclerosis is the most frequent cause of middle ear hearing loss in young adults. It affects about 10% of the U.S. population. It is a disorder that gets worse slowly, usually beginning in early to mid- adulthood. It is more common in women than in men. Otosclerosis usually affects both ears.

Otosclerosis can lead to not only conductive hearing loss, but to nerve loss as well.

Risks include pregnancy (which may trigger onset) and a family history of hearing loss. Caucasians are more susceptible than others to otosclerosis.

Symptoms

  • Hearing loss
  • Slow hearing loss that continues to get worse
  • Hearing may be better in noisy environments than quiet areas.
  • Ringing in the ears (tinnitus)

A hearing test (audiometry /audiology) may determine the extent of hearing loss. Temporal-bone CT may be used to distinguish otosclerosis from other causes of hearing loss.

Treatment

Otosclerosis may slowly get worse. The condition may not require treatment until you having severe hearing problems.

Medications such as oral fluoride, calcium, or vitamin D may help to control the hearing loss, but the benefits have not yet been proved.

A hearing aid may be used to treat the hearing loss. This will not cure or prevent hearing loss from getting worse, but may help relieve some of the symptoms.

Surgery to remove part of the ear (stapes) and replace it with a prosthesis can cure the condition. A total replacement is called a stapedectomy. Sometimes a laser is used to make a hole in the stapes to allow placement of the prosthetic device. This is called a stapedotomy.

Outlook

Otosclerosis gets worse without treatment, but surgery may restore at least partial hearing. Most complications of surgery get better by themselves within a few weeks.

To reduce the risk of complications after surgery:

  • Do not blow your nose for 1 week after surgery.
  • Avoid people with respiratory or other infections.
  • Avoid bending, lifting, or straining, which may cause dizziness.
  • Avoid loud noises or sudden pressure changes such as scuba diving, flying, or driving in the mountains until healed.

Download Otosclerosis Informed Consent

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