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By Texas Ear and Vestibular Institute
January 06, 2020
Category: Otolaryngology
Tags: Ear Infection  

Find out if the ear problems you are having could actually be due to an infection.ear infection

There is nothing fun about having ear problems. Of course, it isn’t always easy to tell if the symptoms you are having are warning you of an ear infection. Knowing the symptoms and when to see your otolaryngologist, Texas Ear and Vestibular Institute in McKinney, for treatment is very important so you can eliminate the infection and get your ear health back on track. If you think you have an ear infection, here are some of the signs to look for.

An ear infection often comes on suddenly. If you are an adult suffering from an ear infection it’s fairly common to experience ear pain and drainage, as well as muffled or lessened hearing. If you suspect that your child might have an ear infection here are some of the most common symptoms:

  • Ear pain
  • Discharge from the ear
  • Lack of appetite
  • Poor balance
  • Irritability or fussiness
  • Problems sleeping
  • Nausea
  • Tugging at ear
  • Having trouble hearing or responding to others
  • Fever of 100 degrees F or higher

While most people don’t immediately see a doctor the minute symptoms arise, you should go ahead and schedule an appointment with your Texas Ear and Vestibular Institute otolaryngologist if:

  • Your symptoms last more than one day
  • A child under 6 months old is displaying these symptoms
  • Your ear pain is serious
  • If your child is having trouble sleeping
  • If you notice pus or blood draining from the ears

There are many reasons for an ear infection, whether it’s from a simple illness or swelling of the Eustachian tubes in the ears. Your doctor will talk to you about the symptoms you are experiencing and then examine your ear. If a virus is to blame (which is often the case) then antibiotics will be prescribed. We can also talk to you about other at-home measures you can take to manage your symptoms and reduce pain and discomfort.

If you are concerned that you may have an ear infection then it’s time to call an ear, nose & throat doctor that you can trust. Call our office today and let us know what symptoms you are experiencing. We will try to get you in right away.

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.
By Texas Ear and Vestibular Institute
December 16, 2019
Category: Otolaryngology

Just like breathing or blinking, swallowing is an involuntary habit that we don’t often think about; however, swallowing is an important part of everything from speaking and socializing to consuming delicious food. Unfortunately, there are disorders that can affect a person’s ability to swallow. A swallowing disorder can be uncomfortable and troublesome, and a visit to an otolaryngologist can give you the answers you’re looking for as to what’s going on.

Some people having pain when they swallow while others may have trouble swallowing certain foods or feel as if there is something stuck in their throat. As a result, they may have trouble getting the proper nutrients and calories they need. Swallowing disorders are more common as a person ages. Swallowing disorders usually fit into one of two categories: esophageal and oropharnygeal dysphagia.

Esophageal dysphagia

People who often feel like they have something in their throats are often dealing with esophageal dysphagia as a result of:

  • Gastroesophageal reflux disorder (GERD)
  • Esophageal spasms
  • Achalasia (esophageal sphincter dysfunction)
  • Scar tissue of the esophagus
  • Tumors
  • Certain medications that can cause dry mouth

Oropharnygeal dysphagia

There are certain conditions that can also affect how the muscles in the throat function, which makes it more difficult to swallow food properly. Common causes include neurological disorders, nerve damage (spinal cord or brain injuries) and cancers of the head, neck, and throat.

Along with trouble swallowing, those with swallowing disorders may also experience:

  • Coughing after swallowing
  • The sensation of food being stuck in the throat
  • Choking
  • Regurgitation
  • Sore throat
  • Hoarseness
  • Chest discomfort

If you experience persistent issues swallowing or if you also experience vomiting, regurgitation, or unexpected weight loss along with swallowing difficulties then it’s time to see an otolaryngologist.

Diagnosing Swallowing Disorders

To determine the cause of a patient’s swallowing problems their ENT doctor will go through their medical history, ask questions about the symptoms they are experiencing and then perform a physical examination. Based on the patient’s answers, your doctor will then determine which testing is needed to make a diagnosis. Common diagnostic tests include:

  • Endoscopy
  • Esophageal muscle test (manometry)
  • CT scan
  • Dynamic swallowing study
  • Barium esophagram
  • 24-hour pH impedance (to evaluate acid reflux and regurgitation)

Treating Swallowing Disorders

As you can see from the list above, there are many conditions and causes that could result in swallowing disorders. Therefore, the treatment you receive will depend on the cause and severity of your symptoms. Your ENT specialist will work with you to create an individualized treatment plan to reduce symptoms. With chronic conditions, your doctor will find ways to help you manage the underlying condition to make swallowing easier.

By Texas Ear and Vestibular Institute
December 04, 2019
Category: Otolaryngology
Tags: Ear Cleaning   Earwax  

Contrary to what you might think, earwax is actually beneficial for protecting your ear from infection. It lubricates and keeps the ear canals clean of bacteria and dirt. Ears are typically self-cleaning, so you shouldn’t have to clean your ears regularly (and in some cases ever); however, sometimes your ears can use a little help. If you are dealing with an earwax blockage, or you are prone to blockages, you will most certainly want to turn to an otolaryngologist to find out the cause of these recurring blockages and ways to keep your ears clean.

Most people use cotton swabs when they clean their ears. The problem with this is that it often serves the opposite purpose, and just pushes the wax further into the ear canal. Using a cotton swab inside the ear can also lead to damage to the ear canal or eardrum. Again, if earwax buildup is a common problem for you this is something you should talk to your ENT doctor about. A simple rule to follow: Cotton swabs should be off limits for cleaning your ears.

Cleaning Your Ears at Home

If you are dealing with a blockage you may be able to remove the earwax yourself with these gentle measures. First, you will want to soften the wax. There are over-the-counter products with a special glycerin solution that can help to breakdown the wax. You can also choose to fill an eyedropper with baby oil or hydrogen peroxide and apply a couple of drops into the ear.

You will want to leave the oil in your ear for up to two days before squirting warm water into the ear canal using a rubber syringe. Again, this syringe can be found as part of an over-the-counter wax removal kit at your local drugstore. Once you have rinsed out the ear make sure to use a towel to dry the outer part of the ear only. If you are prone to ear infections you may want to use a blow dryer to gently dry the ear.

Earwax Impaction

Since everyone’s ears are shaped a little differently this means that the cleaning method that works well for one person might not work as well for another. If you have excess buildup of earwax you may notice:

  • Ear pain
  • Fullness or ringing in the ears
  • Muffled hearing
  • Dizziness

If you wear a hearing aid you may be prone to earwax buildup, so it’s important that you talk with your ENT doctor about ways to reduce your chances for developing impacted earwax. In some cases, doctors may recommend coming in every six months or once a year so they can remove excess earwax safely and effectively without causing damage to the ears.

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).

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