We provide services for all types of ear and vestibular disorders.
Common problems that we treat include:
1. Outer ear infections (Swimmer’s Ear)
Outer ear infections (also called swimmer’s ear or otitis externa) can be caused by bacterial or fungal organisms. The infection is located in the ear canal outside of the eardrum. The usual symptoms of an outer ear infection are pain, muffled hearing, itching, and drainage from the ear. The diagnosis is made by looking in the ear. The treatment is typically a thorough cleaning of the ear canal of any drainage/debris, and a course of antibiotic drops that are put into the ear twice daily.
2. Middle ear infections (Otitis Media)
These infections are usually caused by bacteria. The infection is located behind the eardrum. Typical symptoms are severe pain and pressure in the ear and hearing loss. The diagnosis of a true middle ear infection is usually pretty obvious by looking in the ear- the eardrum is bulging with yellow pus behind it. Treatment is with antibiotics by mouth.
3. Ear pain
The sensation of pain in the ears has a long laundry list of possible causes, many of which are NOT inside the ears. In adults, it is more common that ear pain is caused by pain in the jaw joint (temporomandibular joint, or TMJ) than the actual ear. This article has more information about various causes of ear pain. More information about TMJ pain.
4. Hearing loss (sudden or chronic)
We provide audiology services for comprehensive hearing testing and hearing aid sales every Wednesday in our Kyle office. Usually for new patients with a hearing complaint, we recommend that they schedule on a Wednesday to avoid needing a second visit for their hearing test. Depending on the cause of the hearing loss, a variety of different treatments are available. These include hearing aids, medications, and surgeries. Further information on age-related hearing loss.
5. Earwax cleaning
If your ears are plugged with wax, we can definitely help. You can try flushing your ears at home with Debrox (available without a prescription at any pharmacy). Do NOT use q-tips or stick anything smaller than your elbow inside your ear- this can push wax farther in and can also cause outer ear infections. If all else fails, we have a number of suctions and instruments to remove wax safely in our office. More information on ear wax.
6. Ringing/Noise in the ears (Tinnitus)
Tinnitus is quite common and is usually caused by underlying hearing loss or previous loud noise injury. It is essential to have a comprehensive hearing test to adequately diagnose this problem, so we strongly recommend you schedule for a Wednesday Audio Day in Kyle or you will need to follow-up for a second appointment to complete your hearing test.
7. Drainage from the ears (Otorrhea)
Most often, this is a symptom of an outer ear infection, but can be caused by chronic irritation/inflammation of the ear canal due to eczema or other skin conditions. The diagnosis is made by examining the ear. Treatment is usually antibiotic or steroid drops, depending on the exact cause.
8. Eustachian tube problems (pressure and popping in the ear)
The Eustachian tube is the connection from the back of the nose to the middle ear space behind the eardrum. If the Eustachian tube does not open properly, the middle ear can get clogged with pressure (Eustachian tube dysfunction) or even fill with fluid (serous otitis media). We can treat Eustachian tube dysfunction with various medications, and if those do not work, there are procedures to address this problem too. Although less common, some patients suffer from the opposite problem: their Eustachian tube is always open and never closes tight. This condition is called Patulous Eustachian Tube, and can be treated with medication.
9. Vertigo caused by inner ear problems
Vertigo is a specific term that means “the illusion of movement.” So, patients feel like they are moving when they are not. Usually this is a feeling of the room spinning but it can be other types of movement. Vertigo is not a diagnosis or a condition, it is a symptom just like pain or nausea (despite what patients might be told in emergency rooms or urgent care centers). The trick is figuring out what underlying condition is causing the vertigo. Some vertigo is caused by problems in the ear. The vast majority of inner ear vertigo is due to one of these 4 reasons:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Labyrinthitis also known as Vestibular Neuritis (viral inflammation of the inner ear)
- Meniere’s Disease
- Otitis Media (causing stimulation of the inner ear)
More information on dizziness and vertigo.
10. Migraine associated dizziness
Migraine is one of the most common causes of dizziness and vertigo, possibly THE most common cause of all. Dizziness can occur in migraine patients even in the absence of any headaches, and can be the ONLY clue that patients are having migraines at all. The classic story is periodic spells of vertigo that last for variable lengths of time (some last a few minutes, others an hour or two, and some all day long). The vertigo is usually severe and causes a lot of nausea and vomiting. Typically there is a history of migraines or headaches for the patient (or if not, migraines in a parent or sibling). Migraine associated dizziness is quite common and usually responds well to medications, but it is NOT diagnosed routinely by non-ENT or neurology doctors.
11. Chronic balance problems
“Dizziness” sometimes means imbalance, not spinning vertigo. We can help with diagnosing and treating these patients as well. The most common reason for imbalance is aging, but a myriad of other conditions can affect the balance. A number of neurologic problems cause imbalance, especially balance problems that only occur while walking around. If appropriate, we can refer patients to a neurologist for further evaluation. We also have good relationships with local physical therapists, who can help patients to gain strength and confidence and improve their balance.
12. Speech delay due to hearing problems
Speech delay in children can occur for many reasons, but it is imperative to evaluate the hearing in any child with speech delay. If there is hearing loss, this is usually an easily correctable problem. The hearing loss can be from ear infections/fluid behind the eardrum (most common reason in kids), or due to underlying sensorineural hearing loss. Once the hearing issue is addressed, most kids make rapid gains in their speech. Even if there is no hearing problem, it is essential for the child’s speech therapist to know this information to properly help.
13. Perforated eardrum
A hole in the eardrum can happen for a few reasons: most commonly rupture due to pressure/infection, trauma, or failure to heal after ear tubes fall out. Acute eardrum ruptures from infection or trauma frequently heal closed within a few days or weeks. Chronic perforations of over 1 month typically need surgery to close.
14. Fluid Behind The Eardrum (Otitis Media)
This condition is like a middle ear infection minus the infection part. There is fluid behind the eardrum but it is not infected. The fluid is sometimes thin/watery (serous otitis media) and sometimes thick (mucoid otitis media). Typical symptoms are hearing loss, pressure/fullness in the ear, and no/minimal pain. The diagnosis is sometimes obvious with a simple ear exam (otoscopy) but frequently there are no clear visual signs. In this case, we can perform a quick painless test called tympanometry that checks the pressure behind the eardrum. The treatment for otitis media is typically steroid pills and decongestants. If this does not work after several months, some patients will need ear tubes to clear out the fluid.
15. Many others- please call or send an online appointment request if you are having an ear or balance problem that is not listed.
We have an audiologist available in our Kyle office every Wednesday to provide comprehensive hearing testing. Free hearing aid evaluations are scheduled on Fridays in Kyle.
If you need to be seen for hearing loss, tinnitus, or vertigo and you have not had a recent audiogram, we recommend you schedule an appointment on a Wednesday in the Kyle office. You will then be able to have your hearing test and see Dr. Evans at the same appointment.
Please call us at 512-550-0321 to schedule an appointment today!