Philadelphia ENT
Pediatric ENT

Hearing & Balance

Diseases, disorders or injuries to the ears can not only cause hearing loss but, may also affect balance and quality of life. Furthermore, otologic (ear) problems can also cause neck and face pain.

Hearing and Balance Services:

Hearing Loss

There may be many reasons for a hearing loss. Our experienced University Otolaryngology Audiologists have all of the necessary equipment to provide comprehensive diagnostic evaluations. We work in conjunction with our ENT professionals to best care for your hearing.

Audiology Examinations

An audiogram is a test which determines hearing levels and type of hearing loss.
Audiometric pure tone and speech testing is performed. Tympanometry evaluates mobility of the eardrum and status of the middle ear. Otoacoustic Emission (OAE) testing evaluates the function of the outer hair cells in the cochlea (the hearing organ). The audiologist will discuss the results of the hearing evaluation with the individual and determine what treatment is necessary.

Auditory Brainstem Response (ABR): Evaluates how well sound travels from the auditory nerve to the lower brainstem. An ABR is recommended to rule out any lesion along the hearing nerve that may cause asymmetric hearing loss, ringing in the ears, and/or dizziness. To complete the ABR test, electrodes are placed on the forehead and soft earplugs are inserted into the ear canals. The individual will hear moderate to loud clicking sounds. The individual is instructed to be still, quiet, and relaxed during this test. This test takes approximately 30 minutes.

Eletrocochleography (EcoG): Evaluates the inner ear in suspected cases of Meniere’s disease and other disorders of the inner ear. This test is completed on individuals complaining of spontaneous episodes of vertigo or dizziness, which may or may not be accompanied by tinnitus (ringing/humming/buzzing in the ear/s) and fluctuating hearing loss.

To complete the EcoG test, electrodes are placed on the forehead and soft earplugs are inserted into the ear canals. The individual will hear moderate to loud clicking sounds. The individual is instructed to be still, quiet, and relaxed during this test. This test takes approximately 30 minutes.

Electronystagmography (ENG): Evaluates the status of the vestibular (balance) system in the inner ear. Eye movements are recorded and used to determine the status of the inner ear. This test is completed on individuals complaining of vertigo, dizziness, lightheadedness, or loss of balance. There are many types of medical conditions that can cause these symptoms. Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo. Individuals with BPPV often complain of dizziness when they rotate their head. This type of positional vertigo is usually treated in one or two visits.
The ENG consists of a series of non-invasive tests in which electrodes are placed on the patients face (forehead and next to the eyes). There are pre-test instructions that must be followed 48 hours prior to ENG testing. This test takes approximately 1 hour.

Hearing Aid Services and Dispensing

When medical and surgical intervention have been ruled out, often the best treatment for hearing loss is the use of hearing aids and assistive technology.  Once you have been medically cleared for a hearing aid, the Doctors of Audiology will review the results of your hearing tests and discuss your lifestyle to help determine which hearing aids would be best suited to your needs. All hearing aids today are 100% digital and can be programmed for each individual's hearing loss. They allow us to fit you with a device that is matched specifically to your hearing levels and personal lifestyle. This allows hearing aids to grow with you as your hearing changes. There are different styles, sizes and technologies of hearing aids. Our Doctors of Audiology will go through a hearing aid evaluation with you that will help you decide which is best for your lifestyle and hearing needs.  In some cases, insurances may contribute to the cost of the hearing aids or reimburse you for some of the cost. You can contact your insurance provider to see if this is a covered benefit or can discuss with the audiologist who can also help guide you in this part of the process.

There’s no simple answer to the question of hearing aid prices. The price you should spend on your hearing aids is determined by the combination of amount of use and the type of performance you are looking for. But honestly, there is no way to calculate the true value of being able to hear and speak with clarity.

How much you should spend to enhance your hearing with hearing aids or assistive listening devices depends on many factors: your lifestyle, how often you talk on the phone, whether you live alone, and how often you socialize with others.  Of course the more you use your hearing aids, the more they will help you, and the more you’ll be engaged with your friends and family and the more you’ll get out of life.  And only you can put a price on the value of friendship, family and fully being part of the conversation.

At your initial fitting appointment, the hearing aids are programmed to reflect the type, shape and severity of your hearing loss.  You will be instructed on the care use of the instruments and maintenance of the instruments as well.  All information provided is also contained in the user manual for your specific device for your review at home.  As you wear your new hearing aids you will adjust the sounds that you are hearing.  This is a normal process that will be explained to you.  We will follow up with you for post fitting appointments where adjustments may be made to the hearing aids.  As you wear the hearing aids, and relate your experiences, we will fine tune the functions of the hearing aids to meet your individual needs.

Ponto System - If your hearing loss is due to problems in your outer or middle ear, you may be a good candidate for a bone anchored hearing system like Ponto. Specifically designed to bypass any problems in the ear canal or middle ear, the Ponto System could offer you clearer, more natural listening. The device is implanted through a brief procedure. After your ponto fitting, we activate transferring sounds to the inner ear via bone conduction which completely bypasses problems in your ear canal or middle ear.

CROS or BiCROS Hearing Aid - This may be another option for an individual who has poor to no hearing in one ear. Contralateral routing of signal (CROS) amplification systems are intended to be used when (essentially) one ear is normal or has a mild/moderate hearing loss (i.e., is generally a candidate for amplification) and the other ear is (more-or-less) not “aidable.” CROS hearing aids might be recommended for single-sided deafness (SSD) or for people with very poor unilateral word recognition scores. BiCROS (bilateral microphones with contralateral routing of signal) amplification systems are sometimes recommended when both ears have hearing loss, but one ear hears substantially “better” than the other. A contralateral routing of signals (CROS) hearing aid is a type of hearing aid that is used to treat unilateral hearing loss. It takes sound from the ear with poorer hearing and transmits to the ear with better hearing.

 

Tinnitus/Ringing in the ears

Tinnitus is the hearing of sound when no external sound is present. It can sound like a ringing, buzzing, humming or a mixture of sounds. The diagnosis of tinnitus is usually based on the person's description. A number of questionnaires exist that assess how much tinnitus is interfering with a person's life. While there is currently no cure or remedy to stop tinnitus outright, "learn to live with it" is not an acceptable solution.

Utilizing an FDA-cleared neuroscience-based approach, the Levo System is a personal and patented nightly sound therapy designed to improve the quality of a patient’s daily life.  User-friendly Levo software allows patients to listen to their personalized sound match on an Apple iPod touch®.  Custom fit ear buds, designed to ensure comfort during sleep, allow for optimal positioning and controlled delivery of sound therapy.  The Levo System can identify the unique tinnitus sound of each individual and is specifically designed for use during sleep when the brain is especially responsive to habituation.

The Levo System for Tinnitus - www.Otoharmonics.com

Balance Disorders

Dizziness and balance disorders are among the most common symptoms that cause people to seek medical attention. Very often the imbalance is caused by the vestibular system within the inner ear. Balance disorders can occur at any age but are most common as people get older. Patients usually experience one or more of the following symptoms:

  • Vertigo - the sensation of the person or the room spinning
  • Dizziness
  • The sensation of being off balance
  • Lightheadedness
  • Disorientation
  • Falling or stumbling

The symptoms may last for seconds or even days and vary in severity from being a minor nuisance to actually being disabling. The vast majority of balance disorders are non-life threatening and treatable by means of balance exercises, medication, canalith repositioning maneuvers ( simple maneuvers done in our office) and in certain cases surgery. However, loss of balance may also be a symptom of a severe medical condition requiring appropriate evaluation and treatment.

At University Otolaryngology Associates our experienced physicians and audiologists have specialized training in the evaluation and treatment of patients with balance disorders. We have extensive experience and the appropriate equipment within our offices to do balance testing and we collaborate with local radiology and balance therapy facilities to provide our patients with state of the art care. If you have a concern as to whether or not this is the appropriate practice for your medical condition, please do not hesitate to call our office and ask to speak with one of our clinical staff members.

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