Neurotology is the study and practice of medical and surgical disorders that involve the ear, adjacent brain, and the nerve connections within this region (known as the lateral skull base). In addition to all disorders of hearing and balance, Neurotologists also treat disorders of the facial nerve, tumors of the inner ear and skull base, and abnormal connections between the brain and temporal bone. In actuality, the meanings of the terms Otology and Neurotology overlap quite a bit. Nevertheless, a Neurotologist’s training provides the ability to treat disorders, ranging from simple to complex, that involve the area of the temporal bone and lateral skull base.

Otology is the study and practice of medical and surgical disorders of the ear. These include disorders related to hearing and balance. Some common problems treated by Neurotologists include infections of the ear canal and middle ear (including cholesteatoma and chronic otitis media), eardrum perforations, hearing loss (including conductive, mixed, and sensorineural types), vertigo, and ear ringing. Neurotologists possess Ear, Nose, and Throat training but go on to complete additional fellowship training focusing on Otology and Neurotology.

What is sudden sensorineural hearing loss?
Sudden sensorineural hearing loss is a term used to describe hearing loss that develops over a very short period of time. Sensorineural hearing loss generally implies damage to the structures of the inner ear or hearing nerve. While there are many possible causes of sudden sensorineural hearing loss, in most cases, the cause is unknown.

What are the symptoms of sudden sensorineural hearing loss?
In addition to a sudden drop in hearing (which can occur in a brief instant or over a period of hours), patients with sudden sensorineural hearing loss may experience ringing or noise within the ear and some sense of dizziness or imbalance. The presence of any additional neurologic symptoms (such as slurring of speech, confusion, or weakness of the face, arms or legs), although rare, would suggest that a brain stroke might be occurring and would require immediate evaluation at a hospital.

How is sudden sensorineural hearing loss evaluated?
Patients who experience a sudden drop in hearing should be seen immediately, preferably by an ENT physician or Neurotologist, and a complete hearing test should be performed to determine the extent of the hearing loss. Additional tests, including imaging studies such as an MRI, may be required. Oftentimes, patients attribute their ‘clogged ear’ to a cold or allergies. However, if there is any question of a sudden drop in hearing, it is better to have it checked as soon as possible.

What treatments are available?
Treatment is often available, usually in the form of steroid medications, and is much more effective if provided as close in time as possible to the sudden drop in hearing. In addition to oral medication, medication delivered directly into the middle ear (through the ear drum) may be helpful.

This holiday season, as we gather with family and friends, the crowded rooms and loud, happy environments may emphasize our hearing loss or that of our loved ones even more.  If you are looking for some help, yourself, or a useful gift for someone struggling with impaired hearing, get “The Complete Idiot’s Guide to Hearing Loss.”

“The Complete Idiot’s Guide to Hearing Loss” was written by members of the House Clinic, an international referral center for the treatment of ear and skull base disorders, with chapter contributions from our very own Dr. John Goddard.

Beth Kinney, 64, of Cocoa, Fla., woke up one morning in October 2003 to a spinning room. She had experienced slight vertigo before when she was younger, but never anything this bad. Each doctor she visited said he couldn’t help her.

Kinney was finally referred to Jacksonville Hearing and Balance Institute. It took almost three months of treatment, but she was eventually able to go back to work full time and regain most of her hearing.

“The P.A., Judy Nelson, was very comforting and gave me assurance,” Kinney said. “She worked with me for months to get me to be able to function normally.”

Kinney still experiences slight dizziness when she is stressed or lacking sleep, but nothing like before.

“I would highly recommend Jacksonville Hearing and Balance Institute to anyone who is having a chronic balance or vertigo problem,” Kinney said. “When you run into something that is repetitive in its nature, over and over, I would just suggest that you get help and get it quickly.”

Dr. Green returned to Nigeria in October 2011 to train surgeons, perform ear surgeries and follow up with some of his former patients. He and former missionary Dr. Joel Anthis, of Katy, TX, performed ear surgeries (primarily stapendectomies and tympanoplasties with or without mastoidectomies) in Jos, Nigeria. Dr. Anthis also performed a few non-ear surgeries including endoscopic sinus surgery, laryngoscopy, bronchoscopy and the removal of a foreign body in the lung. Dr. Green and Dr. Anthis performed approximately 13 procedures.

Dr. Green trains Nigerian physicians during surgery

Dr. Green also followed-up with Stephen Kutchin, a Nigerian math professor who lost his hearing in 2002 and had cochlear implant surgery in 2007, performed by Dr. Green in Jacksonville, Fla.

“Stephen is doing well with his cochlear implant and had a celebration for the four years that he’s had his implant,” Dr. Green said. “He invited 30 of his friends and family and described how the implant had changed his life.”

The most common problem the physicians saw was chronic ear infections. There were also several patients who were profoundly deaf from medication toxicities, genetics or meningitis. Both Dr. Green and Dr. Anthis gave lectures to the family practice residents at Bingham University Teaching Hospital and demonstrated various ear surgeries for the ear, nose and throat surgeons.

Inside a Nigerian operating room

“The experience of delivering care in a third world country is always a humbling one,” Dr. Green said. “I am always grateful to be living in the U.S.A. I could have been born in a hut in Nigeria, but by the grace of God I was born in the U.S.A. I really enjoy the people of Nigeria. They are incredibly hard-working, devoted and loving people who are grateful for what we do.”

Watch a slideshow from Dr. Green’s 2011 trip to Nigeria:

Nigeria 2011 from Grace Courter on Vimeo.

Dr. Goddard spoke at the Florida Society of Otolaryngology’s annual meeting on Sunday, November 13 at 10 a.m. in Kissimmee, Fla. “This year’s FSOHNS annual meeting was very informative, ” Dr. Goddard said. “Several excellent talks were given as ENT specialists around the state gathered with the goal of improving patient care.”

An estimated 5.4 million Americans are living with Alzheimer’s disease, according to Alzheimer’s Association, causing problems with behavior, memory and thinking for those afflicted with this condition. Alzheimer’s is the sixth-leading cause of death in the United States.

Studies have shown that hearing impairment in older adults is correlated with the progression of dementia. During the month of November, the Better Hearing Institute along with hearing health professionals around the country is raising awareness about Alzheimer’s disease.

If you have questions about your own hearing or the hearing of a loved one, call our office today at 904-399-0350 or read about our hearing consultations. If you are a caregiver for someone living with the disease, read the Alzheimer’s Association Alzheimer’s Caregiving Advice for some helpful advice.

Several staff members of the Jacksonville Hearing and Balance Institute and some of their loved ones participated in the 17th Annual Susan G. Komen North Florida Affiliate Race for the Cure in Jacksonville, Fla., on October 22.

The day started with a breast cancer survivor breakfast and celebration, followed by the 5K walk and 2K fun run in the downtown area.

“The best part was seeing all the survivors get honored,” Allison Jeffries said. “It was also really neat to see all the family and friends supporting those who had passed away or are still fighting.”

Jeffries participated in the 5K walk with her husband, daughter, grandson, nephew, and two cousins, one of whom is a five-year breast cancer survivor. Paula Johnson walked with her daughter. One of our audiologists, Dr. Elizabeth Pearson, also participated in the walk with her mom, who is a survivor, and her daughter.

“Many of the women at the walk have encountered and overcome the challenges of breast cancer,” Dr. Pearson said. “My mom is one of these women and we were able to walk together with my daughter and realize how grateful we are that she is here with us today. We recognize these challenges as making life interesting and we cherish the fact that overcoming them is what makes life so meaningful.”

Dr. Goddard ran the 2K fun run with his wife. He is enjoying participating in other awareness events as well on the East Coast, as he just joined the practice in July.

“It was truly wonderful to be involved in the North Florida Race for the Cure and to see so many people passionately supporting breast cancer awareness,” Dr. Goddard said.

According to the Better Hearing Institute, older adults with hearing loss also appear more likely to develop dementia. As hearing loss becomes more severe, their risk increases. Researchers who conducted a study published in the Archives of Neurology found that the risk of developing Alzheimer’s particularly increased with hearing loss.

“There is strong evidence that hearing impairment contributes to the progression of cognitive dysfunction in older adults,” says Sergei Kochkin, PhD, Better Hearing Institute’s Executive Director. “Unmanaged hearing loss can interrupt the cognitive processing of spoken language and sound, exhaust cognitive reserve, and lead to social isolation—regardless of other coexisting conditions. But when an individual has both Alzheimer’s and hearing loss, many of the symptoms of hearing loss can interact with those common to Alzheimer’s, making the disease more difficult than it might be if the hearing loss had been addressed.”

Research has also shown that using hearing aids in addition to other appropriate rehabilitation treatments can help reduce symptoms associated with Alzheimer’s disease.

“A comprehensive hearing assessment should be part of any Alzheimer’s diagnosis and any hearing loss should be addressed,” says Kochkin. “Most hearing loss can be managed with hearing aids. By addressing hearing loss, we can help improve quality-of-life for people with Alzheimer’s so they can live as fully as possible. These individual’s—and their families and caregivers—face many challenges. Untreated hearing loss shouldn’t have to be one of them.”

If you would like to schedule an appointment at Jacksonville Hearing and Balance Institute to discuss your hearing health, please call 904-399-0350.