Health Blog | Ear, Nose, & Throat Specialists

Purchasing Hearing Aids Online Poses Serious Risks

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Hearing Aid Lexington

Hearing aids are popular assistive devices that improve quality of life for people of all ages.
Their growing popularity over the past 20 years has resulted in unlicensed and unbranded generic hearing aids being sold online.

But, hearing aid buyers should be aware of the great risk associated with online purchases. Hearing aids purchased online can cause permanent hearing loss or damage. When hearing aids are not custom fitted or adjusted to your specific type and degree of hearing loss, it leads to serious issues. When the volume is too loud or too quiet, within hours, this can cause extreme strain on both the ears and the brain, resulting in problems such as persistent headaches, permanent ringing in the ears, permanent hearing loss – just to name a few. It only takes one truly loud sound to create a hearing loss that lasts a lifetime.

Additionally, when you buy a hearing aid online, there is no or limited warranty or repair support, no one to talk to for advice or help. At a private clinic, on the other hand, you can get an amazing, personalized buying experience. You can get a hearing aid that really works for YOU, and change your life for the better!

We are here to help!

Ear Tubes 101

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Ear Check

Children often have problems with ear infections.  In fact, in many instances it seems as though it is a right of passage in those early childhood years.  Overall, acute otitis media (AOM, aka ear infection) is the most common reason a parent takes the child to the doctor in the U.S.  Roughly 80% of all children have an episode of AOM by the age of 2 years.  However, this does not become a recurrent problem in most children, and only a small group of children require ear tube placement.  The following information is based on the many questions I am asked regarding ear tubes.

Do adults ever need ear tubes?  Yes, but much less common than children.  Some adults will have Eustachian tube problems and develop fluid behind the eardrum that causes a mild to moderate hearing loss.  If medications do not resolve the fluid, then an ear tube can be placed to correct the problem.

How are ear tubes placed?  In children, they are placed in the Operating Room.  The child will have general anesthesia, inhaled gas only (no I.V. medications) for roughly 5-10 minutes total.  Using a microscope and a small scapel, an incision is made through the eardrum and, if present, fluid and infection is removed with a suction and the ear tube placed.  Afterwards, the child will be drowsy until the anesthetic gas wears off (usually within 4-6 hours).  Most adult patients comfortably allow the procedure done in the clinic, using a topical anesthetic to numb the eardrum for tube placement.

When should ear tube placement be considered?  The American Academy of Otolaryngology: Head and Neck Surgery recommends ear tube placement if there are 3 infections within 6 months or 4 infections within one year.  If the infection is cleared but fluid persists (past 3 months) causing hearing loss, then ear tubes can be placed to drain the fluid and improve the hearing loss.

Are ear tubes permanent?  No.  Standard ear tubes typically stay in for 6-18 months.  Larger tubes can stay in longer, but are only used for patients that require multiple sets of ear tubes.  Rarely do they not fall out on their own and require removal.

Can my child swim with ear tubes? Yes and No. Chlorinated swimming pools have been studied and show no significant risk of developing an ear infection.  However, all other water (lakes, oceans, baths, etc) is considered dirty and may cuase the devleopment of an ear infection.  To prevent this, the patient may wear ear plugs that are sold in most pharmacies.  For children that have trouble with the generic ear plugs, our Audiologists can make fitted plugs that work well for most patients.

Can my child develop an ear infection despite having ear tubes?  Yes.  In fact, most patient will have an episode even with the ear tubes.  An ear infection with a functioning ear tube does not cause pain, only ear drainage.  If this happens, only antibiotic ear drops (and not systemic oral antibiotics) are usually needed to clear the infection.  Rarely, the infection and drainage will not clear and the tubes may need removed-replaced.

What complications are there with ear tubes?  There is a 1-2% risk of a hole being left in the eardrum, known as a Tympanic membrane perforation that may need repaired in the future.  Scarring, or sclerosis, of the eardrum is common but is not associated with any hearing loss.  General anesthesia (inhaled gas only) is required for children and there is a very small risk of a reaction to the medication.

My child talks loudly and I am concerned of hearing loss, could there be an ear infection?  Unlikley this is from an infection, but it could be due to persistant fluid build-up behind the ear drum that is causing hearing loss.  A standard hearing test can help make this diagnosis.  The good news is that this is typically treated with medication or an ear tube, and no permamnent hearing loss is noted.

If you have any further questions, then call and make an appointment in one of our conveniently-located offices.

Robert Wilson, MD.

Expanding Care at Saint Joseph ENT Center

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We are pleased to announce that the Saint Joseph ENT Center will now be staffed 5 days a week by our physicians due to the increase in patient demand.  Dr. Lange will join Dr. Wilson and DR. Shashy in providing medical and surgical ENT treatments at the Saint Joseph East Medical Complex.  Not only will the clinic be open 5 days a week, outpatient surgery will be scheduled 3 days on the campus as well.  Full service audiology testing and treatments, including the latest in Hearing Aid technology, will continue to be provided by our audiologists.  The clinic is located on the first floor of the Eagle Creek Medical Plaza building, adjacent to the hospital.  Call 859-629-7140 for  questions and appointments.

Saint Joseph ENT Center

120 Eagle Creek Drive, Suite 102

Lexington, KY 40509

Chronic and Recurrent Sinusitis

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Chronic sinusitis, or chronic rhinosinusitis, is a very common medical illness that is defined as sinus inflammation that lasts three or more months. It is different than acute sinusitis, which involves sinus inflammation for less than four weeks.

The illness affects men and women equally, as well as both pediatric and adult patients. It is estimated that over 30 million patients in the U.S. alone suffer from chronic sinusitis. It is one of the most common reasons patients are prescribed antibiotics.

The pathophysiology is not well understood, but research is ongoing to better understand the disease process. Currently, we believe the ostiomeatal complex (an important site where the majority of the sinus cavities drain into the nasal passages) becomes obstructed. The obstruction can be mechanical, from a septal deviation or polyp, or from membrane swelling, most commonly from allergies or a viral respiratory infection. This obstruction then leads to stasis of mucous, which is a good median for bacterial growth, and acute sinusitis develops. With persistence of the infection, mixed flora, anaerobic organisms, and, occasionally, funguscontribute to the pathogenesis. Most cases of chronic sinusitis are due to acute sinusitis that either is untreated or does not respond to treatment. Rarely, other forms of sinusitis occur, such as a fungal infection or an infection secondary to a dental infection.

Cronoc Sinusitis Graphic (Image taken from Netter's Anatomy textbook)

The symptoms of chronic sinusitis are different than acute sinusitis, as facial pain and fever are usually absent with the chronic disease. The most common symptoms include nasal congestion with posterior nasal drainage, periorbital pressure or headache, bad breath with unpleasant taste, nonproductive cough, and malaise.

The physical exam performed by a physician is often limited as the sinus cavities can not be directly visualized. An ENT physician often will look further into the nasal cavities with a telescope in attempt to see where the sinuses drain and to ensure no polyps or tumors are noted. However, to better visualize the sinuses, radiographic studies, and a CT scan is the gold standard, are needed.

Other laboratory studies, such as blood work, are often not needed. Occasionally, physicians need to rule-out any immune disease disorder or other connective tissue disease, both of which are rare. However, it has been well documented that allergic rhinitis is commonly associated with chronic sinusitis, and that allergy testing may be performed.

Once the diagnosis of chronic sinusitis is made, then physicians will first treat with aggressive medical management. This typically includes a 4 to 6 week course of broad-spectrum antibiotics, such as Augmentin or Levaquin. Other important adjunctive treatments include steroids, nasal and/or systemic decongestants, mucolytics, intranasal steroid spray, and sinonasal saline rinses. If symptoms do not resolve, then surgical procedures then are indicated.

The surgical management of chronic sinus disease has gone through many changes over the past few years. Currently, in nearly all cases, surgery is performed with telescopes (endoscopes), known as endoscopic sinus surgery (ESS). This allows the sinuses to be opened and drained without using any external incisions. The surgical procedure often takes 2-3 hours to be performed, using general anesthesia. A newer technology, known as image-guidance where a computer is used to help guide surgery, is often used if patients have polyps or require additional surgery. Overall, the success rate of the surgery is noted to be 80-90% based on the latest research.

Following surgery, patients may have packing placed in the nose and sinuses (often dissolvable packing can be used). This is to reduce the rate of bleeding after surgery, which can occur in 2-4 percent of patients. Patients will need to avoid heavy lifting or exercising for 2 weeks following surgery to reduce the chance of bleeding. It is imperative for healing that patients keep their nose moist after surgery, using saline sprays and steaming (vaporizing) multiple times during the day. If infection or polyps are noted during surgery, then patients will need antibiotics and steroids continued after surgery. All of these measures are to increase the chance of complete resolution of the chronic sinus disease.

A new procedure, one that is an alternative to traditional sinus surgery, is now available for patients with chronic sinusitis. The balloon sinoplasty technique is a less invasive procedure, with a lower risk of bleeding and pain. Many patients can have this done in an office setting with no general anesthesia. After applying topical and local anesthesia, a telescope is introduced just as in traditional sinus surgery, but a balloon is inserted into the opening of the sinus cavity and then dilated to further open the cavity. The overall time for the procedure is usually around an hour. Studies are showing over 90% patency rates for the dilated sinus openings following the balloon procedure, indicating very good patient responses. However, not all patients may have benefit from this procedure, such as patients with polyps or narrowed nasal cavities.

It is important for patients with chronic sinusitis to understand that this is a chronic disease that often requires long-term treatments and behavioral changes. Many patients need continued allergy treatments following the sinus management. One of the most important behavioral changes is tobacco smoke cessation. Patients that continue to smoke following sinus treatments dramatically reduce their long-term chance of a successful outcome.

Persistent or recurrent episodes of sinusitis despite appropriate medical therapy necessitate referral to an otolaryngologist. Examination, including nasal endoscopy and CT scanning, is required to make a diagnosis of chronic sinusitis. There are both medical and surgical treatments that offer a good prognosis for healing. Any questions or concerns can be further discussed by making an appointment at one of our convenient office locations.

Tips to Prepare for Allergy Season

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Allergy season will soon be in bloom in the Bluegrass region of Kentucky, starting with tree pollen in late February and early March. The first trees to send their pollen into the air will be the flowering dogwoods and pears, then the sugar maple and oak trees. Next, the grasses, including our famous bluegrass, comes in April and May. The season of late summer and early fall is dominated by weeds, primarily ragweed.

If you know what season allergies cause symptoms, then you can try to minimize problems by going on the offensive and getting ready. Here are a couple helpful tips:

1. Keep windows closed in your home and cars to keep pollen outside.

2. Bathe and wash your hair in the evenings to wash off outdoor pollen.

3. Wash your eyes using Natural Tears drops and wash your nasal membranes with Nasal Saline sprays in the mornings and evenings.

4. If you must be outside on a “high count” day, then cover your eyes with sunglasses and your nose with a mask.

5. Start an oral anti-Histamine (OTC or prescription) and/or an eye drop anti-Histaminedaily.

6. If you still have problems, then call our office for an appointment.

“What causes Ringing in my Ears?”

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Tinnitus (pronounced tin-NY-tus) is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. It may be present in either one or both ears. It is estimated that nearly 50 million Americans, nearly 20% of the population in the United States, has experienced tinnitus at some point in their lives.

Tinnitus is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, including: noise-induced hearing loss, age-related hearing loss, hypertension or heart disease, ear or sinus infection, or a brain tumor.

The most common patients who develop tinnitus are ones with noise-induced and age-related hearing loss. We believe that the inner ear cells of these patients have been damaged from years of noise trauma or secondary to nerve degeneration. It is then felt that these damaged cells secrete an energy that the auditory center of the brain perceives as the tinnitus “noise”. Therefore, although the cause of tinnitus begins in the ear, it then continues in the brain.

Despite many of these associated conditions and causes, some people develop tinnitus for no known reason. Most of the time, tinnitus isn’t a sign of a serious health problem. However, if it’s loud or doesn’t go away, it can cause other problems such as depression, insomnia, or problems with memory and concentration. In these few patients, tinnitus can be a source of real mental and emotional anguish.

Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck, just below the ear. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or other structural abnormalities.

The evaluation of tinnitus starts with taking a thorough patient history, identifying any risk factors such as noise exposure, a history of infections, or a family history of hearing loss. A complete examination of the head and neck is then performed to check for abnormalities. A formal hearing test is critical to check for any hearing loss. Based on the findings, further testing with a CT scan or MRI scan may be warranted to make a final diagnosis.

Frustrating to both patients and physicians is that most causes of tinnitus presently do not have a specific cure. Although there is no common cure yet, there are treatments that help many people cope better with the condition.

Hearing aids often are very helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus.

For patients with associated noise-induced hearing loss, prevention of further noise damage is critical. Anything a patient can do to limit their exposure to loud noise – often by wearing earplugs or earmuffs – will help prevent tinnitus from getting worse.

Tabletop sound generators, also known as noise-masking devices, are used as an aid for relaxation or sleep. Placed near the bed, the patient can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. This is all that many patients need to cope with their symptoms.

Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits of the brain, which eventually desensitizes you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a number of study volunteers. However, the device is quite expensive.

Antidepressants and antianxiety drugs might be prescribed by your doctor to improve your mood and help you sleep. Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proven effective in clinical trials.

Counseling helps many patients learn how to live with their tinnitus. Most counseling programs have an educational component to help patients understand what causes tinnitus. Some counseling programs help patients change the way they think about and react to their tinnitus. Patients may learn some things to do on their own to make the noise less noticeable and to fall asleep at night.

If you or a family member have symptoms of tinnitus, then call one of our convenient office locations to discuss this with our physicians and audiologists.


ENT Services Now Available in London, KY

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We are happy to announce that ENT Specialists, PLLC is now staffing the Kentucky One Health SJL ENT Clinic in London, KY 4 days a week.  Dr. Lange will join Dr. Wilson to see and treat pediatric and adult patients in the clinic, located at 1406 West Fifth Street in London.  Outpatient surgical procedures will continue to be performed in the operating room suites at Saint Joseph London Hospital.  Due to high patient demand in the area, we will make ourselves more available and continue to provide high quality ENT care.  Call 606-877-4579 to schedule an appointment.

Saint Joseph ENT Care

1406 W. Fifth Street

London, KY 40741

(606) 877-4579


New Additions to the Practice!

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ENT Specialists, PLLC, is happy to announce the additions of Dr. Robert Wilson, MD, and Dr. Susan Yezzo, AuD., CCC-A. 

Dr. Wilson is moving his practice from Elizabethtown, KY, where he had previously worked at Hardin Memorial Hospital. He received his M.D. from West Virginia University and completed his residency in Otolaryngology: Head and Neck Surgery at the University of Kentucky.  He is board-certified by the American Board of Otolaryngology.

Dr. Yezzo received her AuD. from the PCO School of Audiology.  Before joining ENT Specialists, she was employed as an audiologist by KY ENT.