There are three types of hearing loss: conductive, sensorineural, and mixed. Conductive hearing loss is caused by problems in the middle ear and outer ear, while sensorineural hearing loss is the result of inner ear problems. Mixed hearing loss is a combination of conductive and sensorineural hearing loss.
Sensorineural hearing loss is usually treatable only with hearing aids. Conductive or mixed hearing loss, on the other hand, could be corrected or improved with medical treatment or surgery.
When Is Surgery an Option for Treating Hearing Loss?
A number of factors can cause conductive hearing loss. These include:
- Malformations of the outer or middle ear structures
- Chronic ear infections
- Fluid in the middle ear
- Perforated eardrum
- Impacted earwax
- Foreign objects in the ear
Many of these conditions can be corrected with medical treatment, minor office procedures, or surgery.
What Surgical Procedures Are Used to Treat Hearing Loss?
Stapedectomy is a surgery often recommended for the treatment of otosclerosis, an abnormal growth of bone on or around the stapes, the “stirrup bone” of the middle ear. This abnormal bone growth prevents the stapes from vibrating as it normally would when stimulated by sound waves, causing hearing loss.
Stapedectomy involves removal of the stapes bone and replacing it with a prosthesis. Surgery is usually completed in 90 minutes or less, and often the patient is able to go home the same day. It may take a month or so for results to appear, as there will be swelling and bruising that can impede hearing initially.
Ear tubes are tiny cylinders, made from plastic or other materials, which are surgically inserted into the eardrum to provide ventilation and drainage for children who experience chronic ear infections. They are meant to remain in place from six months to as long as several years; at some point they will either fall out on their own or will need to be surgically removed.
The surgery, known as a myringotomy, is an outpatient procedure usually performed under general anesthesia for small children, or local anesthesia for adults. A small incision is made in the eardrum, fluid behind the eardrum is suctioned out, and the tube is inserted. The procedure is quick and painless, and usually takes no longer than 15 minutes.
Myringotomy is a common and safe procedure, and complications are rare. Rarely, patients will experience a persistent perforation of the eardrum after the tube falls out, scarring or infection.
Tympanoplasty and Myringoplasty
Eardrum perforations are most often caused by infection, injury or eustachian tube disorders. Middle ear infections cause a buildup of pressure that may result in a ruptured eardrum, as can inserting objects like bobby pins or Q-tips in the ear.
While many small eardrum perforations heal on their own, some patients may have to undergo a surgical procedure called a tympanoplasty to repair the hole or tear in the eardrum.
Usually performed under general anesthesia, the hole in the eardrum is patched with a graft made of tissue from the ear or a man-made material. The surgeon will then place packing material on top of and behind the eardrum to keep the graft in place. Over several weeks the material will dissolve.
The surgery can take as little as 30 minutes or up to a few hours.
Small perforations can be repaired in the office under local anesthesia with a procedure called fat graft myringoplasty, where the surgeon uses a small piece of fat from your earlobe to repair the hole. Additional sedation can be offered for patient comfort.
Types of Hearing Implants
Implantable Hearing Devices
There are several different types of implantable hearing devices. At River ENT, we offer cochlear implants and bone-anchored hearing devices.
Cochlear implants are implanted surgically behind the ear and allow those who are profoundly deaf to understand speech and other sounds.
Cochlear implants generate an electrical signal that the brain interprets as sound. The implant has an external portion that sits behind the ear, consisting of a microphone, a speech processor and a transmitter. These work in tandem with the internal components, a receiver and array of electrodes, which are implanted in the ear by a surgeon
Bone Anchored Hearing Devices
Bone anchored hearing devices work via a process called bone conduction. These devices bypass the outer and middle ear and directly transfer sound to the functioning inner ear. At least one ear must have functioning cochlea in order for a patient to be able to use a bone anchored hearing device.
A bone anchored hearing device is useful for patients with conductive hearing loss and single-sided deafness.
At River ENT, we offer bone anchored hearing devices from Cochlear (www.cochlear.com) and Oticon (www.oticonmedical.com).
Call River ENT at (512) 677-6368 for more information or to schedule an appointment.