Pearls of Wisdom

Posts for: December, 2013

By Mark T. Brown, MD, FACS
December 18, 2013
Category: Healthcare

 

Many kids get ear infections, especially in the winter with cold and flu season. A small percentage of kids don’t just get one or two, though. They get a lot. Or they have fluid behind the ear drum that won’t go away. That is when your pediatrician sends you to a place like Great Hills ENT to talk about tubes.

Let’s talk about ears before we start to plan surgery though. The middle ear is the space behind the ear drum. It should connect up to the back of the nose through the Eustachian tube. The purpose of this tube is to drain fluid from behind the ear drum and allow air to fill that space. When you yawn and swallow the throat muscles pull open the end of the Eustachian tube and air moves in and out of the space behind the ear. We call this equalizing because the air pressure in the middle ear should match the atmosphere. Think of taking off on a plane. As the plane rises the air pressure drops and you have to “pop” you ears to equalize them. 

Kids who are sick have a lot of swelling in that tiny little tube so it doesn’t open and close well. The pressure isn’t equalized and the fluid doesn’t drain. Bacteria love to grow in the fluid. Viola! Ear infection.

Tubes work by acting in the place of the Eustachian tube, except that they connect the middle ear to the outside world through the ear drum, not behind from the throat. They keep a little hole open that allows the air pressure to stay equal to the astmosphere. No fluid, no infection. Viola!

Side benefit, kids with tubes who don’t have fluid behind the ear drum hear better – critical for language development and success in school. Also, if there does happen to be an ear infection, antibiotic ear drops are usually all you need. No more yucky oral medicines and all of the problems that come with them.

The surgery, yes it is surgery, can be done on adults in the office. Most kids squirm too much for us to be able place tubes while they are awake. So the 5 minute (you read that right FIVE MINUTE) procedure is done in the OR with them breathing a little gas. Home after that in 15 to 20 minutes. The next day you are back on your usual schedule. Except you might not have to see your pediatrician so often for ear infections.

Bottom line: when a kid needs tubes they are great. Really.

 

Mark T. Brown, MD, FACS

Dr. Mark Brown is an Otolaryngologist (Ear, Nose and Throat) specialist at Great Hills ENT in Austin, TX. Dr. Brown is Board Certified in both Otolaryngology, Head and Neck Surgery as well as Sleep Medicine. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.


 

 

I love listening to live music (if you read my bio, you would know this).  I can’t make it to too many shows (with a toddler at home), but I make an effort when I can. I went to a concert last week and was inspired to write a blog about it.  No, I am not going to write about the great guitar riffs-But I am going to write about “threshold shift.”

Have you ever been to a loud bar/restaurant/concert and left with ringing in your ears and the feeling that you cannot hear very well. This is called a temporary threshold shift, which occurs when you are exposed to loud noises. Usually, after a period of time to recover, your hearing will return back to normal.  Over time and with repeated exposures, this can develop into a permanent hearing loss (called noise induced hearing loss). Rarely, very loud blasts of sound can cause a permanent threshold shift which causes immediate hearing loss.

What can you do to protect yourself? Earplugs!

I know that earplugs don’t look very cool and may not match your concert-going attire. BUT, you have to think about preserving your hearing NOW. Otherwise, you may be wearing hearing aids (which are much more expensive) in order to enjoy the music that you love.  Another possibility is ringing in the ears or tinnitus. Tinnitus is kind of like having your own concert in your head, though probably not one you would choose.  

If you think ear plugs “dampen” the sounds at concerts and the music just doesn’t sound like it should, you might consider musician’s ear plugs, which can be custom made at our office. Protect your ears so you can continue to enjoy your favorite bands in the future. And if you take kids to loud music events, make sure to protect their ears, too.

 

 

Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.  


Austin winters are relatively mild compared to some areas of the country. That being said, we are occasionally hit with a big northern cold front that brings a chill to the air and the need to turn on the heat.  When the moisture in the air decreases, your nose, which acts as a humidifier, may dry out.  When these tissues dry, fragile capillary walls may break and a nosebleed occurs.

A nosebleed may simply be an annoying interruption to your day; however, it can become a larger intrusion that could potentially be life-threatening if it is severe or won’t stop. In some rare cases, it can be a sign of a bigger problem (such as high blood pressure, a clotting disorder, or nasal tumor, to name a few).

For a simple nosebleed, squeeze the front of the nose for five minutes (without checking to see if it stops). Usually, holding pressure will stop most nosebleeds. Spraying a nasal decongestant (such as afrin) will help the vessels in the nose constrict. Do not lean your head back (the blood will just go down the back of the throat) or stick anything up it, as tissues and cotton may get stuck. If the bleeding is severe, won’t stop, or you feel light headed, you should go the Emergency Room.

To prevent the nasal tissues from drying out, you may use some Vaseline in the front of the nose to keep it moist, spray nasal saline into the nose, or use a humidifier. If your nosebleeds are severe or recurrent, make an appointment with one of our providers.

 

 

 

Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.  

                           Image source: http://online.wsj.com/news/articles/SB10001424052702303914304579191842804420788

 


By Paige Peterson, AuD, PhD, CCC-A, FAAA, ABA
December 05, 2013
Category: Tinnitus

Tinnitus (Ringing In Your Ears) Austin, TX

 

Ringing, crickets, mosquitos, whooshing, roaring, hissing, an out-of-tune flute section. All of these things can be used when describing the serenade that is happening in your head, and no you're not crazy.

A day does not go by where I am not asked about tinnitus, or ringing in the ears. To a certain extent everyone has tinnitus at some point. It is quite natural for you to hear a high pitched ring or buzz periodically, lasting just a couple seconds. It is when the time between these events gets shorter and shorter and the duration of the ringing becomes longer and longer that tinnitus becomes an issue.

This personal symphony that you have acquired has many origins. These include but are not limited to: noise exposure, change in blood pressure and blood flow, change in oxygen levels to the brain/ear, pharmaceutical drugs, high frequency hearing loss, sustained high temperatures, head trauma and can accompany different vestibular syndromes/diseases.

Will it go away? Maybe, maybe not. For example, if you have been at Austin City Limits (ACL) and you find that your ears are ringing the day after, it might go away. More importantly why were you there without earplugs? Back to tinnitus, at this point that ringing is your body’s way of telling you to knock it off, you have done damage to the sensory cells of the cochlea and the nerve fibers of your auditory nerve. Initially this can subside, but it can be permanent.

So you have tinnitus, now what? Well, if you’re like me and it drives you crazy and is an all day, every day kind of thing there are treatment options. It doesn’t matter if you have hearing loss or not, there may be something to help. Before you go down this path realize that the damage on that nerve is unique to you, and the level of relief is not something we will know until we try. These options run the gamut from oscillating fans to tinnitus retraining therapy (TRT), ear level masking devices, and hearing aids. What is suitable for you depend on the intensity and your individual needs. Personally, I wear hearing aids to get rid of my tinnitus. And for the record, no I do not have hearing loss and no you can't see them.

But wait a second; I saw this vitamin in CVS that will get rid of it…

Will it work? Maybe, probably not.  The ear is the smallest and most complicated organ in our body. The exact origins of the tinnitus and affected area are unknown. The FDA really doesn’t like us cutting into your head and removing your cochlea. So, that option is out. There hasn’t been a reproducible study that shows any long-term benefit from the supplements. So, as always buyer beware.

For more information:

 

Paige Peterson, AuD, PhD, CCC-A, FAAA, ABA

Dr. Paige Peterson is an Audiologist at Great Hills ENT in Austin, TX and specializes in hearing related disorders including tinnitus and hearing loss, neurophysiological disorders as well as dizziness/balance disorders.  Dr. Peterson is Board Certified in Audiology and is currently accepting new adult and pediatric audiology patients. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, hearing aids, dizziness/vertigo and sleep disorders.


By Great Hills ENT
December 03, 2013
Category: Vertigo
Tags: VNG   ENG   dizziness   dizzy   Epley Manuver   BPPV  

 

Dizziness is a distressing problem. When your ability to enjoy normal movement is suddenly taken away, you feel helpless. And, some dizziness may be a warning sign of serious problems.

Fortunately, there is one type of dizziness that is fairly easy to treat. It is called B.P.P.V. , or, Benign Paroxysmal Positional Vertigo. The symptoms usually occur when you are lying in bed and turn your head. Suddenly you feel like you are spinning. It only lasts a few seconds, but who is counting! With the attack, there are no other symptoms. This important distinction separates BPPV from dizziness caused by more serious problems.

When we evaluate you, we test you by putting your head in a position that recreates your symptoms while examining your eyes for the tell-tale rapid, involuntary movement of the eyes called nystagmus. If it is proven that you have BPPV, we use a simple maneuver to treat it. No medications, no surgery.

The underlying problem in BPPV comes down to loose microscopic particles, in the inner ear, called 'otoliths'. The movement of a loose otolith is similar to when you shake one of those snow-scenes in a lucite globe. Imagine the snow floating slowly down. Until it all settles, this is the force that is causing your dizziness. The maneuver to treat it depends on recognizing which ear has the 'loose snow', then moving the 'globe' in such a manner that the particles are secured from random movement.

If you have more questions please refer to the Vestibular Disorders Association.

 

Barry Castaneda, PA-C

Barry Castaneda, PA-C is a Physician Asssitant at Great Hills ENT in Austin, TX. Barry Castaneda treats disoders or the Ear,Nose and Throat for adult and pediatric patients. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.