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Acute Sudden Sensorineural Hearing Loss (SSNHL) is a rare otological condition with an incidence of 5-20 cases per 100,000 people per year including children, adults and the elderly. SSNHL should be treated as an otological emergency and your GP or audiologist can call the practice directly to book an urgent appointment. In this scenario DON’T WAIT TO BE CONTACTED.
For an unknown reason, since 2020 Dr Anderson has seen an increase in cases presenting to his clinic. SSNHL can present as aural fullness, raging tinnitus and hearing loss and leads to feeling anxious and disorientated. SSNHL is defined as a hearing loss of 30dB or more over at least three contiguous frequencies, over a period of up to 72 hours.
Act early to prevent permanent loss of hearing. Immediately see your GP and request an urgent audiology review and test within 12-24 hours. There are plenty of local audiology companies familiar with this including Attune Hearing, Clarity Hearing and Balance, Amplifon, Bay Audio, Specsavers and Hearing Australia.
Your GP should immediately commence oral steroid treatment. Discuss the risks, benefits and alternatives with your GP. Your GP should refer you to Dr Anderson immediately for a consultation. Dr Anderson will require an audiology report.
Please call our rooms and speak to us about an urgent appointment with Dr Anderson. Dr Anderson will determine whether you require further radiology or pathology investigations.
Ear Wax (known as cerumen) is normal. Wax impaction can cause hearing loss, fullness, tinnitus and ear pain.
Home ear cleaning may harm your ear canal, cause infection, increase wax impaction, put a hole in your ear drum or result in middle ear injury. Cotton wool buds, hair pins, toothpicks and fingernails are all items our ENT surgeons have found in compacted ear wax removed from patients’ ears.
An ear toilet or suctioning will painlessly remove any wax, fungal debris or foreign bodies.
We have regular appointments for ear toilets and a referral from your GP lasts for 12 months from the date of your first appointment, so you can attend as many times as necessary.
Otitis Media with Effusion indicates fluid is trapped behind the ear drum. It is a common condition in children and can cause reversible hearing loss. Acute Otitis Media (middle ear infection) is an infection of this fluid.
Symptoms include ear pain, fever, irritability. Sometimes this can rupture with a release of fluid and reduction in symptoms.
An examination with a otoscope is recommended and often a hearing test.
First line treatment includes treatment of nasal conditions, nose blowing and sometimes antibiotics. Suctioning is recommended to clean out any fluid or debris if a rupture has occurred. If this fails to help grommets are often recommended.
Acute Otitis Externa is commonly referred to as an outer ear inflammation or Swimmer’s Ear and is one of the most common presentations to our clinic.
Acute otitis externa is common in North Queensland due to the high temperature and humidity, perspiration and exposure to water from swimming. Pre-existing conditions such as psoriasis, eczema and dermatitis can result in a higher predisposition to otitis externa. It can be either bacterial or fungal in nature and can be associated with a perforated tympanic membrane.
Referral to our ENT surgeons by your GP is required. An ENT consultation will involve a thorough medical history, list of medications, a head and neck examination, otoscopy and thorough cleaning to remove any mucopurulent debris.
The treatment applied will depend upon whether it is bacterial or fungal in nature. Medical treatment must be strictly adhered to resolve the inflammation and/or infection.
Follow-up appointment may be required to clear away cream or debris to determine if treatment is effective. Stubborn cases of acute otitis externa can take several visits of supervised treatment by an ENT surgeon to resolve.
Call or ask your GP to call our rooms if the case is urgent.
Otorrhea means discharge from the ear. This is often due to a hole in the ear drum.
Otorrhea after grommet insertion is very common. In one study in young children, the incidence was almost 50%. Most will occur shortly after insertion or occur associated with rhinorrhoea (nasal discharge).
Occasionally patients will have troublesome otorrhea that is resistant to treatment. Significant risk factors for otorrhea include socioeconomic status, cigarette smoke exposure, rhinorrhoea and craniofacial anomalies such as a cleft palate.
A review by an experienced ENT surgeon is recommended. First line of treatment includes a proper examination and obtaining a swab for histopathology. Often tissue spearing is recommended to clean out any mucopurulent debris and the use of topical antibiotics.
Intratympanic Dexamethasone Perfusion or titrations are performed under a sterile environment in our NQ ENT consultation room to treat Acute Sudden Sensorineural Hearing Loss, Meniere’s disease and other conditions.
These perfusions are usually performed in a series over several weeks for the purpose of reducing inflammation of the inner ear. There are side effects to the use of a corticosteroid and these will be discussed prior to consent for perfusion.
Meniere’s Disease is a disorder of the inner ear which can result in imbalance, vertigo (spinning), hearing loss symptoms, ringing in the ears (tinnitus), pressure symptoms, nausea and vomiting. It was first reported by Prosper Ménière in 1861. Attacks are usually spontaneous and can be associated with low frequency sensorineural hearing loss.
It is important to seek a referral to a specialist otologist, such as Dr Anderson, to ensure you are accurately diagnosed and consider treatment options.
Keeping a journal of your symptoms is a good idea to help with correct diagnosis and some tests which might be ordered include an audiogram, MRI and balance testing.
Some of the treatments include dietary modification, medications, middle ear injections, vestibular physiotherapy or surgery.
Benign Paroxmyal Positional Vertigo (BPPV) is another form of dizziness which is prompted by head movements such as rolling over in bed or looking up that last for seconds at a time. Severe cases result in an inability to control eye movements.
It is useful to keep a diary of your symptoms or, if possible, take a video of your eyes when feeling dizzy. This can be useful for correct diagnosis.
A review with Dr Anderson will involve a full medical history (including any head injuries or falls), full head and neck examination, detailed vestibular and ocular examination. Dr Anderson may request a MRI scan, to rule out other causes for the dizziness, and request an electronystagmography (ENG) or videonystagmography (VNG).
Treatment may include vestibular physiotherapy, canalith repositioning or surgery.
Implantable Hearing Devices include middle ear implants, bone anchored hearing aids, cochlear implants and brainstem implants. Dr Anderson is accredited by Cochlear Corporation, MedEL Australia and AB Bionics to implant their devices.
For hearing impaired persons there are many disadvantages to conventional hearing aids such as discomfort, poor fitting, wax impaction, poor sound quality, lack of high frequency benefit, feedback or background noise amplification.
The advantages of an implantable device include reduction or elimination or occlusion effect (blockage) and feedback, improved comfort (particularly for swimmers) and improved sound by direct stimulation.
The disadvantages for having an implantable device include cost, risks associated with undergoing a surgical procedure and potential to worsen residual hearing.
Do I qualify?
Dr Anderson will schedule you a specific implant assessment consultation including:
Dr Anderson will refer you to:
The final step is multi-disciplinary team approval by the audiology provider and other ENT surgeons which involves and MDT meeting to ensure the recommendation for implantation is supported.
What happens during implant surgery?
Cochlear implant surgery takes place in the Mater Hospital in Townsville. The surgery lasts about two hours.
What are the risks of implant surgery?
Implant surgery is generally a safe surgical procedure, however, as with all surgery there are risks which will be discussed by Dr Anderson in your consultation but can include: failure to achieve goals, bleeding, swelling, infection around the implant, tinnitus, dizziness and vertigo and injury to the facial nerve.
What happens after surgery?
A recipient is not allowed to drive or operate heavy machinery for at least 48 hours. Some people experience a difference in hearing right afterwards and others experience it when the implant processor is connected.
Two weeks following surgery you will see Dr Anderson for a post operative appointment and wound check.
You will have an appointment with your audiologist approximately 4-6 weeks following surgery for electrode ‘switch on’.
Otosclerosis is defined by the Royal Australasian College of Surgeons as a hereditary disorder that causes progressive hearing loss which may occur in one or both ears. Often an audiologist will recommend you seek a referral to an ENT surgeon.
The diagnosis of otosclerosis can be made following an audiogram and clinical examination by an ENT surgeon. Your ENT surgeon will require a detailed medical history including any health problems you may have had, and any medications you may be taking.
The treatment of otoscelerosis may include watchful waiting, use of hearing aids or surgery, commonly in the form of a stapedectomy.
Eustachian Tube Dysfunction is a condition where the pressure generated in the middle ear is not released properly to the nasal cavity. It is a very common condition. Typically it causes a feeling of fullness, pain with flying and a hearing loss.
Audio entry and pressure testing pick can indicate this condition. Having a cold or flu makes it worse.
Investigation includes examination of the back of the nose where the Eustachian tubes sit and the ear.
Treatment includes ensuring the nasoendoscopy is as clear as possible and occasionally grommets or balloon tuboplasty.
Your ENT surgeon will discuss the risks, benefits and alternatives to these procedures.
Patulous Eustachian tube dysfunction is where the Eustachian tube remains completely or intermittently open, rather than being closed. Usually the cause of patulous eustachian tube dysfunction is unknown.
Commonly suffers report being able to hear their own voice or pulse or breathing loudly. Classically symptoms get better with a cold or flu. Symptoms may include a feeling of fullness in the ear, tinnitus, autophony, hearing loss or suprathreshold hearing.
It is a very discomforting condition and can result in anxiety when breathing, especially when exercising.
Medical treatment may involve weight loss/gain (if medically indicated), increasing fluid intake, nasal saline drops or irrigations to improve hydration of mucosa.
If medical treatment is not successful, surgical treatment may include myringotomy with tympanostomy tube replacement or reconstruction of the valve of the eustachian tube lumen.
Your ENT surgeon will discuss the risks, benefits and alternatives to these procedures.
Myringoplastyis an operation to repair a perforation of the ear drum. A perforation may result in a constantly discharging ear, frequent ear infections, hearing loss, build-up of granulation tissue. It may also occur as a result of disease such as cholesteatoma.
Myringoplasty will need to be performed under a general anaesthetic and may require an overnight stay in hospital. Each perforation is different and our surgeon will discuss in detail the surgery required.
Commonly a tissue graft is harvested and is fixed to the ear drum. Your surgeon may also wish to explore the middle ear space to ensure there is no further underlying pathology.
Your recovery will take 1-2 months. Up to 5% of grafts fail and further surgery may be required.
Stapedectomy is an operation to bypass the effects of otosclerosis on hearing. It involves removal of the stapes bone and replacement with a piston. Other options include hearing aids.
Your surgeon will discuss in detail the risks, benefits and alternatives of this procedure.
Mastoidectomy is a procedure to remove the mastoid air cells behind the ear canal. This can be done for access to the inner ear structures or to removed infection from this area. It can be combined with performing a myringoplasty and ossicular chain reconstruction.
Ossicular Chain Reconstruction is a procedure to repair the ossicles (hearing bones) of the middle ear. They can be damaged due to infection and trauma. Often reconstruction with a prosthesis results in the re establishment of hearing.
A grommet is a tube in the ear drum to allow equalisation of pressure from the middle ear. Infants and school aged children commonly suffer from ear infections.
Many ear infections will resolve on their own, particularly if they are viral in nature. If an infection is bacterial in nature, often antibiotic treatment will resolve the infection. Recurrent ear infections can lead to fluid building up in the middle ear space. Problems can then arise such as hearing loss, pain, poor behaviour, speech and language difficulties, poor balance and poor performance at school.
A review by an ENT surgeon will require an otoscopy of both ears to assess the anatomy of the ear. It may also be necessary for a swab to be taken for pathology to ascertain the microbiology causing the infection.
Ear tubes or ventilation tubes are commonly referred to as grommets. Ear tubes/grommets may be recommended for repeated middle ear infection, known as acute otitis media or for hearing loss caused by persistent middle ear fluid, known as otitis media with effusion.
A myringotomy is performed which involves a small incision in the ear drum or tympanic membrane and an ear tube is placed within the hole to permit air to reach the middle ear space. Grommet insertion is one of the most commonly performed surgeries for children requiring a general anaesthetic. The average age for ear tube insertion is 1-3 years of age.
Source: American Academy of Otolaryngologists and Head and Neck Surgeons.
Note: The Mater Group provide a useful guideline for what to expect if admitted for grommet insertion here.
Tonsillectomies in children are one of our most common procedures performed by NQ ENT surgeons. Our ENT surgeons look for a number of indications for surgery including obstructive sleep apnoea, recurrent infections and the specific risks, benefits and alternatives to surgery in children.
Tonsils (and adenoids) can grow large and obstruct the airway making it difficult to get into a deep sleep. Snoring during sleep is not enough to diagnose obstructive sleep apnoea. It is important to observe the child during sleep to ascertain the nature of the snoring and whether there is a gasp/s for air. When it is unclear, your ENT surgeon may request a polysomnogram which will study the child’s sleep pattern.
There are many non-surgical options such as watchful waiting, weight loss, medications and positioning during sleep. It is important that you understand the risks of and complications following surgery and these will be explained by the surgeon during your consultation.
The most common complications post operatively in North Queensland are de-hydration and bleeding. It is our policy that the child remains within 1 hour of the Townsville area for 14 days post surgery.
Surgery will involve a general anaesthetic and an overnight stay in hospital. An overnight stay in the Intensive Care Unit is often recommended for infants and children with co-morbidities.
Note: The Mater Group provide a useful guideline for what to expect if admitted for Tonsillectomy here.
Adenoids are tissue which is located in the back of the nasal cavity and they trap bacteria and viruses that you breathe or swallow. This is very important for infants and children. Often the adenoids can swell, particularly during an infection, and remain enlarged. This may result in difficulty breathing or swallowing and ear infections.
It is important that you understand the risks of and complications following surgery and these will be explained by the surgeon during your consultation. It is also common for adenoids to grow back after surgery and repeat surgery may be required in older children.
The most common complications post operatively in North Queensland are de-hydration and bleeding. It is our policy that the child remains within the Townsville area for 14 days post surgery.
Surgery will involve a general anaesthetic and an overnight stay in hospital. An overnight stay in the Intensive Care Unit is often recommended for infants and children with co-morbidities.
Note: The Mater Group provide a useful guideline for what to expect if admitted for Adenoidectomy here.