Environmental Medicine

Otolaryngology-Ears

The ear serves as the organ for both hearing and balance. It is subject to a wide variety of infectious, environmental, inflammatory, and allergic pathologies. This page summarizes some of the otologic conditions managed by Dr. Gregg Govett.

External Ear:

The external ear canal can be affected by something as common as cerumen (ear wax) or as complex as skin cancers in the canal. The ear canal has a propensity for infection (swimmer's ear) and skin inflammation due to its status as a dark, damp, warm area. Rarely, clinical problems in this area are manifestations of systemic illness.

Middle Ear:

The middle ear is commonly infected in infants and young children. The surgical procedure, Myringotomy & Tube, is the most common surgical procedure performed on children in the United States. If the ear infections are not controlled with the tubes, an allergy and immunology workup is initiated. Tympanic membrane (ear drum) perforations resulting from infections or ear tubes are repaired by a tympanoplasty in an outpatient surgical center.

Inner Ear:

The inner ear is often the cause of hearing loss in elderly patients. Audiograms (hearing tests) are used to determine the extent of hearing loss and whether the patient is a candidate for a hearing aid. Balance symptoms can be a result of pathology in the inner ear. An ENG, or electronystagmogram, is used as the main diagnostic test in dizziness evaluations. Certain balance conditions are the result of medications or certain systemic dysfunctions.

Eustachian Tube Dysfunction:

The eustachian tube is the small tube that connects the middle ear to the nasopharynx behind the nose. It is the source of symptoms when descending in an aircraft. Eustachian tube dysfunction is often the result of allergies or upper respiratory infections. Management of the etiologies of eustachian tube dysfunction will often lead to improvements in pathology in the middle ear.

Hearing loss:

Hearing loss is a significant cause of disability. It can be related to noise exposure, infection, or simply a consequence of the aging process. Hearing loss is evaluated by a physical examination and audiogram. Hearing aids, surgery, infection/allergic control, and cerumen (ear wax) removal are used to manage this common clinical problem.

Balance dysfunction:

Balance dysfunction can lead to significant health problems due to falling in elderly patients. It is also a significant disability as it impairs driving and walking. The physical examination and ENG are often used in the initial evaluation of dizzy patients. Often, medications and other systemic problems are the cause of the balance complaints. Laboratory evaluations are sometimes needed to evaluate the problem. Treatments are based on the evaluations and can be medications, physical therapy, or rarely, surgery.

Facial Nerve Disorders:

The nerve that controls facial movements courses through the temporal bone; the temporal bone houses the organs of hearing and balance in the skull. Bell's Palsy is a viral infection of the facial nerve that results in paralysis of one side of the face. There are other causes of facial nerve paralysis that can require a consultation, examination, laboratory evaluation, MRI scanning, and rarely surgery. Treatment is based on the findings of the patient evaluation.

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