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By Texas Ear and Vestibular Institute
February 24, 2020
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Feeling dizzy for a while after an intense roller coaster ride is normal; reading in a moving vehicle may cause you to feel nauseated. These uncomfortable feelings are temporary, but for people with a vestibular disorder, they last for days or weeks. Fortunately, the staff at Texas Ear and Vestibular Institute - Dr. Andrew Senchak and Dr. Margo Stewart - in McKinney, TX, are highly trained in diagnosing and treating the dizziness and nausea associated with vestibular disorders. Read on to learn more.

What is vestibular disorder?

Your ears are a small part of your body, but they are made up of a vast network of bone, cartilage, and blood vessels that not only control your hearing, but your sense of balance as well. The fluid inside the ear canal provides signals to the brain upon movement, which then adjusts for both subtle and quick activity. Disruption to the way your vestibular system functions causes uncomfortable symptoms that your ENT will discuss in the next section.

What are the symptoms of vestibular disorder?

People with vestibular disorder often seek medical attention from their ENT after a period of time in which they feel dizzy, off-balance, or disoriented. Some of our patients at the Texas Ear and Vestibular Institute in McKinney also report feeling nauseated or being unable to walk properly. These symptoms can have a negative effect on your entire life; driving, sleeping, and interacting with other people can be a challenge to those with vestibular disorder.

What causes vestibular disorder?

Pinning down the cause of vestibular disorder can be complicated. An untreated ear infection can lead to dizziness and balance problems. Tiny calcium deposits in the ear canal is another common cause. Certain medications may produce side effects that cause vestibular disorder, and those who have had a traumatic brain injury may have lasting effects on their vestibular system. Discussing your medical history with your ENT will help determine what's causing your vestibular disorder.

To schedule an appointment with Dr. Senchak or Dr. Stewart, contact Texas Ear and Vestibular Institute in McKinney, TX, at (469) 678-2211 for an evaluation today.

The inner ear is a series of fluid-filled organs encased within a bony labyrinth. These organs serve two purposes - hearing and maintaining your balance.

 

Your organ of hearing is called the cochlea. The cochlea is a snail-shaped organ filled with hair cells that are organized by frequency. Hair cells that are tuned to higher pitched sounds are located at the basal end of the cochlea where sound waves are originated. Low pitches are tuned at the farthest end of the cochlea, called the apex. When fluid displaces these tuned hair cells, a signal gets sent via your cochlear nerve to your brain for your brain to interpret the sound.

 

 

Your vestibular system is a complex group of organs that work in conjunction with your vision and your proprioceptive system (knowing where your body is in space) to maintain your balance. When the fluid within these organs are displaced, they send signals to your brain informing you of movement and your orientation relative to gravity.

  • There are three semicircular canals that detect angular acceleration of the head (i.e., rolling over in bed). These canals are offset from one another so that they pick up head movements in all directions. 
  • The utricle and saccule are small organs that detect linear accelerations of the head (i.e., riding in a moving car). It is within these two organs that calcium carbonate crystals are embedded within a gelatinous membrane. 

 

A condition called benign paroxysmal positional vertigo (BPPV) occurs when the calcium carbonate crystals within the utricle and saccule get displaced into one or multiple of the semicircular canals. BPPV is characterized by brief episodes of vertigo, usually only lasting for a few seconds at a time, caused by changes in head position. This is most often experienced when lying down or rolling over in bed. BPPV is the most common form of vertigo, but luckily, it is often the easiest to treat. 

 

Other disorders of the inner ear include:

  • Meniere’s Disease - an increase in fluid pressure within the inner ear resulting in vertigo attacks, fluctuating hearing loss, tinnitus, and a perception of fullness within the ear.
  • Noise-Induced Hearing Loss - hearing loss resulting from exposure to loud sounds
  • Vestibular Neuritis - inflammation of the vestibular nerve 
  • Presbycusis - hearing loss due to aging
  • Ototoxicity - damage to hearing (and balance) from medications

 

Fun facts about the inner ear:

  • The cochlea coils around itself 2 ¾ times.
  • As we age (and with noise exposure) our ability to hear high-pitched sounds decreases first. This is because sound enters the cochlea into the higher-pitched region, wearing it out faster.
  • The cochlea is approximately the size of a pea.

The middle ear is an air-filled cavity that has many different parts. It consists of:

  • Eardrum
  • Two middle ear muscles -
    • Stapedius muscle
    • Tensor tympani muscle
  • Eustachian Tube
  • Auditory Ossicles (middle ear bones) - 
    • Malleus (hammer)
    • Incus (anvil)
    • Stapes (stirrup)

Functions of the Middle Ear:

  1. Match the low sound resistance of air to the high sound resistance of cochlear fluids – Sound enters the ear as a pressure disturbance of air. Our organ of hearing, the cochlea, is a fluid-filled organ. For those of us who have tried to talk underwater while swimming, we know that sound does not pass through water well. Because of this, the bones of the middle ear function as a lever system in order to make sounds louder, and therefore more audible.
  2. Protection – We have two muscles in our middle ear. These muscles contract in the presence of loud sounds. This stiffens the movement of the middle ear bones in order to protect our hearing.
  3. Pressure Equalization – The Eustachian tube is a small canal that opens and closes when we swallow, yawn, and chew. When the Eustachian tube opens, it equalizes the pressure in the middle ear space to match that of the environment that we are in.

 

What can go wrong in your middle ear?

  • Otitis Media – Fluid build up in the middle ear space can either be infected or not. Either way, it impacts the movement ability of the auditory ossicles, hindering our ability to hear. When fluid in the middle ear becomes infected, our ears can become very painful and can sometimes result in a fever or a perforated ear drum.
  • Negative Pressure – Allergies, coming into or out of an ear infection, and going up or down in elevation can cause our ears to become pressurized, especially if we cannot naturally equalize the pressure between our middle ears and our outside environment. In these cases, it is common to feel as though we need to pop our ears.
  • Perforated Eardrum – A hole in the ear drum can occur from ear infections or trauma. Trauma can occur from very loud sounds, quick and extreme pressure changes, and physical impacts such as a Q-tip hitting the eardrum. Often times, perforated ear drums heal on their own; however, in some cases, surgical intervention may be needed based on the size or location of the perforation in the eardrum.
  • Cholesteatoma – A cholesteatoma is a collection of dead skin cells and debris that builds up in a retraction pocket of the eardrum or middle ear space. These are common in people who have had a history of multiple repeated ear infections, eardrum perforations, ear surgeries, or a familial history of cholesteatomas.
  • Otosclerosis – Otosclerosis is an abnormal growth on one or multiple of the auditory ossicles (most commonly on the stapes). This prevents the auditory ossicles from vibrating freely, hindering a person’s ability to hear appropriately. Depending on severity, otosclerosis is treated by routine monitoring and use of a hearing aid or surgical intervention.
  • Mastoiditis – Mastoiditis is an infection of the bone in which the middle and inner ears are located. This is often a result of untreated middle ear infections and can be very serious if not treated promptly.

 

Fun facts about the middle ear:

  • The space of your middle ear is approximately the size of a dime.
  • The auditory ossicles are the smallest bones in the human body.
  • Middle ear infections are more common in children because their Eustachian tubes lie perpendicular to the ground, hindering their ability to open and close properly. As we grow, our Eustachian tubes grow into a 45-degree angle with the ground, making it easier for them to open and close more freely. 
  • Hearing loss that has its origin in the middle ear system is often able to be medically managed or monitored. Furthermore, this type of hearing loss affects the volume of sound and not its clarity, allowing patients to be very successful with a hearing aid(s).
 

Welcome to the first of a four part series on the different parts and purposes of the ear. Lets start by talking about the outer ear!

The outer ear consists of two parts, the auricle or pinna (the part that you see when you’re looking at the ear) and the external auditory canal.

Your outer ear isn’t just an earring holder. It also has several functions that contribute to our hearing and well-being.

  1. Protection - Your ear produces a bitter-tasting waxy substance in order to keep bugs at bay. It also has hair in order to prevent dirt and pollen from reaching your ear drum.
  2. Amplification - Your ear has a resonant frequency (pitch), meaning that it functions at its best between 1000 and 4000 Hz. Because of this, for sounds that fall within this range, there is approximately a 15-20 dB increase in volume. Luckily, this is the frequency range that most speech sounds are located.
  3. Localization of sound - The patterns of the folds of your auricle create inaudible echoes when sounds hit it. These echoes blend with the original sound, helping the ear decipher where a sound is coming from.

 

What can go wrong with your outer ear?

  1. Impacted ear wax – Impaction of ear wax has two different causes: over production of ear wax and ear wax being pushed into the ear by the use of Q-tips. Either of these issues results in sound not being able to reach the ear drum properly, hindering your ability to hear appropriately.
  2. Foreign bodies – These can include bugs, cotton left over from a Q-tip and any other small object a child could put in their ear (i.e., beads, peas, toy pieces, rocks, etc.)
  3. External Otits (also known as Swimmer’s Ear) – Swimmer’s Ear is an ear infection of the outer ear that is often caused by leftover water in the ear canal, allowing bacteria and fungus to grow. This type of ear infection is common in people who go swimming often or who have very bendy ear canals.
  4. Trauma – This can include burning your ear on a curling iron, getting cauliflower ear from boxing, or a new ear piercing getting infected, just to name a few.

 

Fun Facts about the Outer Ear:

  • Your ear canal is about an inch long.
  • Your auricle or pinna never stops growing.
  • Your ears are naturally self-cleaning. The hair in your ears helps the ear wax that you produce work its way out of your ear naturally.

Thank you for visiting Texas Ear and Vestibular Institute! Here at TEVI, we are happy to help with all of your balance and hearing needs. We look forward to seeing you in the office soon!

 

On October 24th, we hosted the McKinney Chamber of Commerce for a Ribbon Cutting and Open House in honor of the opening of TEVI. To view pictures of the event, click Ribbon Cutting.



McKinney, Texas ENT | Texas Ear and Vestibular Institute | 1441 Redbud Blvd McKinney, TX 75069 | Phone (469) 678-2211 | Fax (469) 678-2253 ENT in McKinney Call For Pricing Options