Ear surgery procedures

Written by nadia benavidez
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There are parts of the human ear that still baffle scientists--tiny intricate parts all working together to provide us with hearing and balance. Thanks to advances in computer technology as well as in ear surgery itself, the opportunity to offer hearing to those living with life-altering ear conditions has been realised.

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Cholesteatoma and Tumors

Tumours can form inside or behind the ear. A tumour that's growing inside your head could spread to the middle or inner ear and destroy your balance and hearing. Sudden difficulty hearing, severe pain in the ear and dizziness could be symptoms of a tumour. CAT scans or infrared imaging is used to check for a tumour. Depending on the tumour's location, surgery could be minor or life altering. Surgery performed on or around the ear can have the following risks: deafness, permanent vertigo and palsy. An untreated tumour or growth in the ear will lead to deafness, vertigo, palsy and eventually death.

Skin cancer growths or tumours on the outside of the ear are common. Most can be removed easily, but in certain circumstances half or more of the external ear is removed.

A cholesteatoma is a benign growth that normally starts in the middle ear. If a cholesteatoma continues growing into your inner ear it will cause deafness. Symptoms of a cholesteatoma include hearing loss and reoccurring or foul-smelling discharge coming from the ear. Some cholesteatomas can be removed with a simple procedure through the ear canal. Others require a procedure known as a mastoidectomy. After a mastoidectomy, most of your ability to hear in that ear is gone. If a cholesteatoma is left untreated it could grow into your brain and be fatal.

Perforations

The eardrum is a translucent piece of flesh at the end of the ear canal needed to hear sounds. It can be damaged by an object being placed too deep in the ear, by an untreated infection or by head trauma. Small holes or tears in the eardrum usually heal without medical attention. If you have a perforation that is not healing or have extensive eardrum damage it can be corrected. A tympanoplasty is a surgical procedure that uses a skin graft to reconstruct an eardrum. Skin is taken from behind the ear and used to create a new eardrum or seal up a large hole. Tympanoplasties are routinely performed with very high success rates.

Calcium Deposits

Behind the eardrum--in the middle ear--are three tiny bones. These bones rock back and forth together to provide us with hearing. Calcium deposits can build up around these bones, hindering their movement. Hearing is suddenly lost as these bones stiffen and can no longer move. The bones in your middle ear could also be shattered or damaged by trauma to the head. A stapedectomy is the surgical procedure done to replace damaged bones or remove calcium deposits in the middle ear. Stapedectomies have come a long way and now have higher success rates and longer lasting results. There are still some serious risks involved, as with all ear surgeries, and stapedectomies include the following risks: irreversible damage to the middle or inner ear, palsy and permanent deafness.

Deafness

Cochlear implants offer an alternative to deafness to people born deaf or who lost their hearing from disease or trauma. The cochlea is located deep in the inner ear behind the middle ear bones. The cochlea houses tiny nerves that transmit hearing to the brain. Without this nerve centre we wouldn't hear. When trauma, disease or a birth defect causes those nerves to die or not develop properly, the cochlea becomes useless. An implant uses an electrode strip placed inside the cochlea to mimic nerve function and send sound signals to the brain. Candidates undergo multiple tests to determine how their brain would respond to an implant. After the procedure, speech and hearing therapy is recommended for at least one year. Cochlear implant operations have all the risks of major surgery. There is also a small chance of implant device failure, in which the failed device would have to be removed and a new one implanted.

To find out if you are a candidate for this operation, visit the Cochlear Americas website and search for a clinic in your area.

This operation is life changing for those who have successful implants, so with that motivation the field continues to advance.

Hearing Loss

Hearing aids have been used since the late 1800s. Modern hearing aids offer exceptional digital sound quality and hide discreetly inside your ear canal. As of 2009 hearing aid evolution introduced three types of implantable hearing aids to the market. Hearing aid implants are for people suffering from partial hearing loss--not total deafness.

Ear canal implants use a microphone and sound processor like a traditional hearing aid. The implant is placed in skin folds on the external ear, then an opening is made leading into the ear canal. Sound travels through the implant to be amplified and into the ear canal to be heard. An ear canal implant isn't for people with perforated eardrums, middle ear problems or a history of ear infections. Ear canal implants are ideal for people with high-frequency nerve damage hearing losses.

Middle ear implants use a transducer inserted between the middle and inner ear, and the remaining portion of the device is placed under the skin behind the ear. Sound enters the ear and is amplified by the implant behind the eardrum. Middle ear implants were approved by the United States Food and Drug Administration in August of 2000. Middle ear implants are recommended for patients who have nerve damage hearing loss and have tried conventional hearing aids but weren't satisfied.

Mastoid bone implants use a device that transfers sound through the bone behind the ear to be heard by the nerves in the cochlea. A base is attached to the bone with a screw and the device attaches to the base. This allows for removal of the device in order to program, clean or change the battery. Mastoid or bone implants are for people who have healthy, functioning cochleas but severe damage to their eardrum or middle ear. Bone implants work very well for people who suffer from reoccurring ear infections and ear drainage.

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