Neurotology


Midwest Ear Institute is both an otology and neurotology practice. Otology encompasses the anatomy and physiology of the ear and its sensory systems as well as the diagnosis and treatment of conditions related to it. Neurotology is related to otology but also includes the parts of the brain and nervous system that are involved in hearing and balance. Specializing in both otology and neurotology allows us to provide a wide range of expertise and services that cover the full range of ear care. This includes surgically treating neurological conditions like acoustic neuromas and Bell’s palsy.

Acoustic Neuroma

Also known as a vestibular schwannoma, an acoustic neuroma is a noncancerous tumor that develops in the ear. This slow-growing tumor forms on the vestibulocochlear nerve which leads from the brain to the inner ear. This nerve plays a role in hearing and balance so being impacted by acoustic neuroma can affect these sensory systems. Exact causes are unknown but acoustic neuroma can be linked to issues with a gene on a specific chromosome.

Common symptoms of acoustic neuroma include:

  • Hearing loss: It is estimated that 90% of people who develop acoustic neuroma also experience one-sided hearing loss as a result. This makes it difficult to hear in environments with background noise, sound may be muffled or slurred, identifying where sounds are coming from can be challenging, participating in conversations feels tiresome, missing parts of what someone says can become common, etc. Reduced capacity to hear strains communication which can take a toll on social life, relationships, and work performance.
  • Tinnitus: this symptom describes hearing a noise in the ears when no external sound is present. This noise is often described as a ringing, buzzing, or clicking-like noise that can come and go or be constant. Tinnitus makes it challenging to complete daily tasks, maintain focus, affect sleep, and also hearing.
  • Balance issues. The vestibular nerve is essential in maintaining balance. So acoustic neuroma can contribute to unsteadiness, vertigo, dizziness, falls, etc.

Diagnosing acoustic neuroma can take some time because symptoms are often shared with numerous other ear-related conditions. We use different tools including audiological evaluations and imaging tests to effectively identify acoustic neuroma.  Treatment options include surgically removing the tumor or radiation therapy which applies targeted radiation to the tumor to stop its growth.

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Facial Paralysis/Bell’s Palsy

Bell’s palsy is a temporary form of paralysis or weakness on one side of the face. This occurs when the nerve that controls the facial muscles becomes irritated or inflamed. The exact causes of this nerve damage are unknown but experts suggest that it can be triggered by a viral infection. Common symptoms of bell’s palsy include: droopiness on one side of the face, tearing, drooling, loss of feeling in the face, uncontrollable movement of the muscles that control facial expressions (smiling, winking, closing eyelids, etc.). Bell’s palsy typically occurs rapidly with most people reporting going to sleep normally and waking up to a side of their face drooping. Others report this taking a few days.

Diagnosing Bell's palsy involves ruling out other conditions that can also cause facial paralysis. Our expert physicians review symptoms, medical history, and conduct the most effective tests to properly diagnose bell’s palsy. Some people recover without treatment and others can benefit from the different available treatment options. This includes prescribed oral steroids and antiviral medications.

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Skull Base Surgery

The skull is made from bone and cartilage which forms the face and cranium (what surrounds and protects the brain). Skull base surgery is a treatment option used to address growths or abnormalities with the skull that is causing health conditions. This includes cysts, tumors, growths produced by infections, and cerebrospinal fluid. These growths can produce symptoms including facial pain, dizziness, visual challenges, facial paralysis, hearing loss, and headaches.

To diagnose growths or abnormalities that require skull base surgery, we use different imaging tests. This includes brain imaging tests like MRIs, MRAs, and CT scans which provide pictures of the skull. Other tests could include balance, hearing, and vision evaluations. Skull base surgery can be conducted endoscopically which is minimally invasive. Most commonly, it involves making a small incision in the nose, inserting an endoscope, a thin tube with a camera, and using medical instruments to remove the growth.

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