Patient Information
Symptoms of Ear and Hearing Problems
Ear and hearing problems can be very serious conditions that should not be taken lightly. If you are experiencing one or several of the following symptoms contact UPMC’s Ear and Hearing Center to schedule a consultation:
- ear pain
- deafness
- hearing loss
- sudden hearing loss
- dizziness
- facial weakness or paralysis
- ear drainage
- bleeding of the ear
Conditions We Treat
The following are some of the many ear and hearing conditions treated by the Ear and Hearing Center team at UPMC:
Acoustic Neuroma
Acoustic neuromas are one of the most commonly occurring growths within the ear. This type of benign tumor can lead to gradual hearing loss, ringing in the ears, and loss of equilibrium.
Acute and Chronic Ear Infections
An acute ear infection (also referred to as acute otitis media, see below) is a common cause of ear pain, ear drainage and hearing loss. Fluid can persist behind the ear drum following an acute infection or after an air flight. When an infection has been present for longer than three months it is defined as chronic. Chronic ear infections may be accompanied by the development of a cholesteatoma (see below).
Cancer of the Ear and Temporal Bone
Cancer can arise in the ear canal or the deeper structures of the ear within the temporal bone. Cancers that arise from adjacent structures, such as the parotid gland, can also invade the ear.
Cerumen (wax) Impactions
Cerumen (ear wax) is made by the special glands of the ear canal. Excessive wax accumulation may obstruct the ear canal and cause hearing loss. The wax is gently removed from the ear canal using an ear microscope and special instruments.
Cholesteatoma
A cholesteatoma is a growth of skin forming a cyst that can lead to
recurrent infections of the ear and surrounding bone, and can cause hearing loss, dizziness, and facial weakness.
Conductive Hearing Loss
Conductive hearing loss occurs when sound vibration cannot get from the outer ear to the inner ear. This can occur from cerumen in the ear canal, perforation (hole) in the tympanic membrane (ear drum), or problems with the ossicular chain (small bones of hearing in the middle ear). The source may be from trauma, erosion from infection, or restricted movement from fixation or scarring.
Deafness
There are three types of hearing loss: conductive (see above), sensorineural (“nerve loss”) or mixed (a combination of the two). Hearing loss may range from mild to profound. The type and severity of hearing loss will determine the approach to therapy including observation, hearing aid amplification or surgical correction.
Eardrum Perforations
Eardrum perforation is a hole in the eardrum that can occur following extrusion of ventilation tubes, trauma, acute or chronic ear infections, or associated with cholesteatoma. Symptoms and signs may include repeated acute ear infections, pain, drainage from the ear, and hearing loss. Surgical repair is often necessary to avoid future infections and improve hearing.
Facial Weakness and Paralysis
The facial nerve travels through the ear into cheek carrying nerve impulses to move the muscles of the face. When the facial nerve becomes weak, the face may droop on the affected side creating an asymmetric smile and difficulty closing the eye. One of the most common causes of facial weakness is a viral infection called Bell’s palsy. Trauma causing a fracture of the temporal bone may cause weakness or paralysis of the face. Acute or chronic ear infections, as well as benign or malignant tumors, can also cause facial weakness. It is important to be evaluated within several days of the onset of facial weakness because treatment is often most effective when initiated early.
Glomus Tumor
A glomus tumor is a benign growth in the middle ear or jugular fossa (skull base) that causes local bone destruction, ear fullness and often pulsatile tinnitus (sounds of blood flow in rhythm with the heart beat). Hearing loss is also common. Occasional voice and shoulder weakness may develop.
Otitis Externa
Another term for this infection of the outer ear canal is swimmer's ear. This is usually a bacterial infection initiated by a scratch or trauma to the ear canal and exposure to contaminated water or an increase in humidity. Less commonly, infections in this location may be secondary to fungal invasion of the ear canal.
Otitis Media
This is an inflammation of the middle ear that is especially common among children. Antibiotics often relieve this condition, but in cases where otitis media fails to respond to antibiotics, a myringotomy can be performed to drain fluid from the middle ear. A ventilation tube can be placed to maintain aeration of the middle ear.
Otosclerosis
Otosclerosis is a progressive hereditary condition of the temporal bone which can result in conductive, and rarely, nerve hearing loss. The stapes bone becomes fixed, which limits sound vibrations from reaching the inner ear. The resulting hearing loss may be rehabilitated with a hearing aid or surgery.
Skull Base Tumors (benign and malignant)
Various tumors may develop in the bone located at the base of the skull including acoustic neuromas (see above), glomus tumors, and squamous cell carcinomas. Surgical treatment of these tumors often includes a multidisciplinary approach in conjunction with a neurosurgeon and/or a head and neck cancer surgeon. Radiation and/or chemotherapy may also be utilized in the treatment of some skull base tumors in consultation with radiation oncologists and oncologists at our medical center.
Sudden Hearing Loss
Sudden hearing loss occurs rapidly over a short time period (1-2 days). Potential causes include wax impaction in the ear canal or fluid behind the ear drum. Occasionally, problems in the inner ear can cause a sudden “nerve”-type hearing loss. Evaluation of sudden hearing loss includes a hearing test and may include an imaging study such as an MRI. Treatment for sudden nerve hearing loss is often more effective when initiated early so it is beneficial to be evaluated within several days if you experience a sudden change in hearing.
Tinnitus (noise in the ears or head)
Tinnitus is a common problem that affects about 44 million Americans. People with tinnitus hear ringing in their ears but there is no corresponding external source of the noise. There are multiple causes of tinnitus. Although there is currently no cure for tinnitus, our specialists work in partnership with our audiologists to offer a variety of medical and acoustic treatment options to our patients, including the use of hearing aids, medications, background sound, tinnitus maskers, and tinnitus retraining therapy.
Depending on your condition the physician will work with you to determine the best treatment plan. Your treatment may consist of surgery, therapy, hearing aids, and/or implants. The following are just some of the treatments offered at the UPMC Ear and Hearing Center. One or several of these procedures may be a part of your treatment plan.
Myringotomy and ventilation tubes
A surgical procedure to open the eardrum and remove fluid from the middle ear. Sometimes a small tube is inserted in the middle of the ear to maintain drainage. This surgery is most often performed on children, but is sometimes performed on adults.
Tympanoplasty
A surgical procedure performed on the eardrum and/or middle ear bones to restore the middle ear hearing mechanism.
Mastoidectomy
An operation used to remove disease from the bone located behind the ear.
Stapedectomy/Stapedotomy
A surgical procedure used to treat otosclerosis in which the stapes bone is removed and replaced with a prosthesis. Hearing may be better right away, but some bleeding behind the eardrum may keep hearing reduced. Very significant improvement in hearing should occur within 10 days to two weeks after surgery.
Otologic laser procedures
Using lasers with micro-millimeter spot size and accuracy, extremely delicate ear procedures are performed minimizing trauma to the inner ear compared to other surgical techniques
Cochlear implant surgery
A cochlear implant is a surgically-implanted electronic device that helps provide sound to a person with severe hearing loss. This is hearing loss usually caused by damage or a defect in the inner ear. Cochlear implants bypass damaged hair cells in the inner ear and directly stimulate the auditory nerve to send information to the brain.
Osseointegrated bone conduction hearing system (Baha)
This procedure surgically places a bone anchored hearing aid (Baha) to the skull to transmit sound through the bone to the inner ear. This implant allows sound to bypass the external auditory canal and middle ear.
Intratympanic therapies
This treatment involves medication being injected through the tympanic membrane (ear drum) into the middle ear to treat cetain conditions of hearing loss or dizziness. There may be a single or series of injecions.
Gentamicin injections–intratympanic injection of gentamicin is a vestibulotoxic medication that chemically reduces function of the inner ear. This is used for treatment of inner ear disorders causing recurrent vertigo.
Steroid injections–intratympanic injection of steroids is used for people with sudden hearing loss when they are seen near the time of onset.
Acoustic neuroma surgery
Depending on your hearing status and the size and location of the tumor, your doctor will select one of the following surgical methods to remove the acoustic neuroma:
Translabyrinthine –the doctor removes the mastoid bone and bone in the inner ear for access to the ear canal to remove the tumor. This approach is often used when hearing is already minimal.
Retrosigmoid/Sub-occipital –an incision is made through an opening in the skull, behind the mastoid part of the ear. This approach is used for large or small tumors, and makes it easier for the surgeon to view the facial nerve and to save the hearing.
Middle Fossa –the tumor is removed from the upper surface of the
internal ear canal beyond the inner ear. This approach is used when there is a good chance that hearing may be preserved.
CyberKnife radiosurgery
CyberKnife radiosurgery is a technique to treat ear and hearing disorders that are related to brain conditions. It uses a highly focused beam of radiation to target specific areas of the brain. Since the beam of radiation destroys the tissue that a surgeon would remove with a scalpel during an operation, no actual cutting is involved in the procedure.
Labyrinthectomy–a transmastoid surgical procedure that
eliminates remaining inner ear balance function from the diseased ear causing vertigo and disequilibrium.
Congenital atresia repair–surgical reconstruction of the ear canal, tympanic membrane (ear drum), and ossicular chain (middle ear bones of hearing) for people who were not born with these parts.
Particle repositioning maneuver–benign parosxysmal positional vertigo is caused by minute calcium crystals floating freely in the inner ear. This is a therapeutic maneuver which redirects the particles back in the part of the inner ear where they belong.
There are several patient services that makes the UPMC Ear and Hearing Center a top ranked program. UPMC offers a minimally invasive and comfortable examination process that allows some patients to experience their exams on a 17-inch monitor. This new technology provides a more detailed examination of patients’ ears allowing patients to see their ear drums, which increases patients' understanding of their conditions. This technology also may record the examination in order to keep a visual record of the patient's progress and treatments.