- Ear InfectionsWhen a patient has long standing or recurrent problems with ear infection, or drainage from the ear, we term this chronic ear disease. Patients need to realize that having draining of pus and infection from the ear is an abnormal symptom. Chronic ear disease is a spectrum of problems which might include a hole in the eardrum, thickening of the mucosal lining of the middle ear space (mucosal hypertrophy), or ingrowth of skin from the outer surface of the eardrum to within the middle ear space, and formation of a skin cyst that we call a cholesteatoma.
- GlaucomaIf you are currently using eye drops for glaucoma, please make sure these are not Beta Blockers. These must be discontinued prior to the scheduled test date.
- Anxiety
- MRIMeniere’s disease is for the most part a clinical diagnosis. The Hallmark symptoms of episodic vertigo with ear pressure, tinnitus, and fluctuating frequency nerve hearing loss help to diagnose it. If a patient has these symptoms then it is very likely that they have Meniere’s disease. It may be necessary to undergo an MRI scan to ensure that there is no inner ear tumor present. It is necessary for patients with suspected Meniere’s disease to have hearing tests and advanced tests of hearing function, as well as advanced tests of the vestibular function of the inner ear. The ENG test measures the relative strength of the vestibular system in the inner ear and gives us an idea of how weak a person’s vestibular system is, and how this will affect their prognosis. Sometimes a patient will have the symptoms of Meniere’s disease but it is difficult for us to localize the disease to one ear or the other. This can be a problem especially when medical treatment is not successful.
- RadiologyYes, if you have records or radiology films that pertain to your office visit bring them with you. If you have been referred by another physician, arrange with them to get a copy of your records or have them send a copy for you. Our doctors prefer imaging films instead of discs if available.
- Computed TomographyIn most cases, we can visualize the opening of a cholesteatoma using our surgical microscopes in the office. A patient who presents with a history of drainage from the ear might respond to antibiotic treatment, but if this drainage recurs over and over it may be a cholesteatoma. A CT scan may or may not be ordered. Sometimes a CT scan can be very helpful in predicting how much damage has been done, and at other times the CT scan does not give us a great deal of information. Rarely, an MRI scan could be indicated. It is very important to recognize that hearing tests are valuable in helping to diagnose and manage patients with chronic ear and cholesteatoma. Sometimes a hearing test may show subtle changes that a patient does not notice, which gives us information about the extent of the cholesteatoma. These hearing tests are particularly valuable in following a patient in the long run after they have had treatment. A specialized test called an ENG may be ordered to evaluate the balance function of the inner ear in a patient with cholesteatoma.
- Ear SurgeryOwens Ear Center, experts in hearing loss diagnosis, ear surgery & medical treatment of hearing loss & balance disorders in the Dallas Fort Worth Metroplex in North Texas.
- OtolaryngologyDr. Bob has authored several scientific articles in the medical literature regarding ear disease, and worked with surgical prosthesis companies to develop new and improved prostheses for hearing reconstruction. He serves as a member of the Board of the Hearing School of the Southwest, and the Dallas Foundation of Otology. He is a past president of the Texas Academy of Otolaryngology.
- Cyst
- AllergiesIn most cases, we can treat patients with Meniere’s disease with lifestyle changes and medicines and drastically reduce the frequency and severity of their Meniere’s attacks. We recommend to all of our Meniere’s patients that they choose a specific low salt diet plan of their preference, but that keeps their total sodium intake less than 2000-3000 mg per day. Tight control of sodium intake can help with Meniere’s symptoms to an astonishing level. It is also recommended that patients eliminate caffeine and nicotine from their diet, and it is important for patients to realize that alcohol can irritate the inner ear as well. There are a variety of medications that we can prescribe to help with Meniere’s by increasing blood flow to the inner ear or acting as a diuretic. Any patient who has Meniere’s disease and the slightest allergy symptoms should be screened with allergy testing and begin immunotherapy (allergy shots). Research has shown that immunotherapy greatly helps control the attacks of Meniere’s disease. A certain type of medicine called vestibular suppressant helps to stop the dizziness when it occurs. We use Valium in a very low dose to help control Meniere’s attacks and to stop them when they occur. The dose is quite low and it is extremely rare that a person has side effects such as “feeling drunk” or drowsiness. Occasionally we may use oral steroids in an attempt to break up a cycle of attacks if a person is having a sudden burst of attacks. All of these medications generally help control the vertigo, but unfortunately they do not have much of an effect on the pressure, tinnitus, and fluctuating hearing loss.