Broomfield • Brighton • Golden

Experienced Ear Specialists in Denver

Ear Issues & Problems | Broomfield •Golden •Brighton Colorado

In order to understand ear conditions, it is important to learn about the ear. The ear is made up of four parts: 1) the outer ear or pinna, 2) the external ear canal, 3) the middle ear, and 4) the inner ear. Each of these areas is susceptible to infections or injury. Infections of the ear canal are commonly known as “swimmer’s ear” infections. Young children have a greater tendency to get middle ear infections (otitis media). Both ear canal and middle ear infections are very painful and often require medical and sometimes surgical treatment. A good ear examination is necessary to determine the source of the problem and how to treat it.

Some of the disorders we treat include:

ear diagram

Our Ear Specialists Department

Cholesteatoma

Ear Tubes

Otosclerosis

Otosclerosis is a condition affecting the temporal bone, the bone containing the structures of the ear. Normal bone becomes replaced with disorganized “spongiotic” and “sclerotic” bone. This usually affects the part of the temporal bone around the oval window, which is the interface between the stapes, or third bone of hearing and the inner ear.  This causes calcification and stiffening of the ligament that supports the stapes, reducing its ability to vibrate and transmit sound effectively. This causes a conductive hearing loss, which implies a mechanical problem regulating sound from the environment to the inner ear, where it is detected. In some cases otosclerosis may progress to the inner ear itself, causing a sensorineural hearing loss. Otosclerosis affects up to 10% of the white population. It is much less common in other ethnic groups and impacts women more commonly than men. It occurs in both ears to some degree in the majority of patients, though it may progress at varying rates. Otosclerosis also tends to run in families.

Treatment Options for Otosclerosis include Hearing Aids and Surgery.

What happens during surgery?

Surgery is usually performed under general anesthesia. Depending on the size and shape of the ear canal, surgery can often be performed with a single small incision hidden inside the ear canal. Occasionally though, a small extension of the incision out of the ear canal and into the crease in front of your ear may be needed. The eardrum is lifted up to access the middle ear. A small portion of the innermost ear canal bone is removed to access the stapes and oval window. The stapes is separated from its attachment to the incus. A laser is then used to divide a tendon attached to the stapes, as well as the portions of the stapes connected to the footplate (part that is within the oval window). The stapes is removed with the exception of the footplate, which is left in place. A laser and very tiny drill is used to create a precise hole in the footplate into the inner ear. A prosthesis called a stapes piston is then positioned between the incus (hearing bone that was connected to the stapes) and the hole (stapedotomy), thus restoring the connection between the mobile hearing bones and the inner ear. The eardrum is then repositioned and secured in place with some tiny pieces of absorbable packing sponge.

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Vertigo

Eardrum Perforation

Ear Infection

External Ear Canal (Otitis Externa)

Ear Canal Infections, a.k.a. otitis externa, swimmer’s ear – Also known as “swimmer’s ear,” outer ear canal infections result from bacteria or fungus causing the canal to swell. Moisture in the air or swimming makes the ear more susceptible to this type of ear infection.  Symptoms include severe pain, itching, redness and swelling in the outer ear that leads to a “plugged” feeling and often muffled hearing. There also may be some fluid drainage. Pain is worse when chewing and even touching the outer ear can be quite painful. Treatment of otitis externa usually requires ear drops and can be simple to manage if caught early.  Complications from untreated otitis externa may include hearing loss, recurring ear infections, or bone and cartilage damage. Sometimes an ENT can help the process by clearing out the infection in the office with specialized instruments. Most outer ear infections resolve with appropriate treatment in about a week.

Middle Ear Infection

Middle ear infections, a.k.a. otitis media – Middle ear infections occur behind the ear drum and can be caused by either bacterial or viral infections. These infections may be triggered by allergies, infections elsewhere in the body, or a blocked Eustachian tube that connects the ear to the back of the nose. This is the most common type of infection in children, although it can occur in adults as well. In some cases fluid may linger in the middle ear and cause muffled hearing. Treatment of otitis media depends on the cause of the infection and ranges from oral antibiotics to surgical insertion of a pressure equalization  tube to drain fluid from behind the ear drum. Often enlarged adenoid tissue in the back of the nose is the root cause of the problem by obstructing the Eustachian tube. In children, an adenoidectomy is sometimes necessary in conjunction with tubes.

Inner Ear Infection

Inner ear infections, a.k.a. labyrinthitis, vestibular neuritis – Inner ear infections are most commonly due to a virus, and may be associated with other signs of an upper respiratory or sinus infection. Bacterial inner ear infections are rare but can occur, and usually spread from an untreated middle ear infection. Symptoms include dizziness, nausea, vomiting, hearing loss, tinnitus (ringing), and sometimes facial weakness attributed to Bell’s Palsy. Inner ear infections may resolve on their own, but you should seek medical attention to determine the underlying cause, especially if there is hearing loss. Sudden hearing loss associated with these symptoms needs urgent treatment that is best administered by an ENT.

Ear Wax

 

Cerumen, also known as earwax, is an important part of normal ear health. The yellowish substance is secreted by glands in the skin of the outer portion of the ear canal. It helps lubricate and protect the skin of the ear canal, repels water (which can cause infection if it remains in the ear), traps and helps remove dust and small particles that enter the ear, and inhibits growth of bacteria and fungus. In a normal ear, the cerumen will slowly work its way out of the ear canal, and you may see small amounts come out from time to time. In the vast majority of cases, no specific cleaning measures are needed for the ear, except for maybe wiping the outside of the ear with a damp cloth when bathing to remove dirt and debris from this area. Objects such as Q-tips, hair pins, keys, etc. should never be inserted into the ear canal. In addition to risking injury to the ear, this practice works against the ear’s natural self-cleaning measures by pushing material deeper into the ear canal.

In some ears, especially in ears that have been probed with Q-tips or other objects, cerumen builds up and becomes impacted deep in the ear canal. This can cause hearing loss, ringing in the ears, mild off-balance, pain and even infection. When this occurs, removal of the cerumen by a medical professional is often the best solution. ENT physicians use delicate tools under a microscope to remove the cerumen without causing injury to the ear canal or eardrum.

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