GENERAL ENT
Ear

“Blindness separates people from things; deafness separates people from people.”

Helen Keller, deaf and blind American author (1880-1968).

The ears, as organs of hearing and balance, are two of the most important sensory organs which are fundamental to our connection to the world. They provide the main gateways to the ENT area via the Eustachian tubes. Ear symptoms can be extremely debilitating.  Ear problems may arise throughout life in all sorts of forms. Problems may include impacted ear wax, hearing loss, recurrent ear infections, glue ear, (chronic) ear discharge, ear pain, hearing loss, tinnitus (a sensation of ringing or buzzing in the ear) and various combinations of these, amongst many others. You may also visit us for problems with your balance, dizziness or vertigo (a spinning sensation). As the hearing and balance organ are closely related anatomically and functionally, problems of the balance organ will for the most part be analyzed in the same way as ear problems. 

Ears symptoms usually stem from a problem within the ear itself, but they may also be a manifestation of problems in other parts of the body. In some cases, a systemic disease in another organ system can produce a problem in the ear, such as recurrent infections of the external ear canal in patients with diabetes. Ear symptoms may also result from problems in other parts of the ear-, nose , and throat area. A poignant example of this is an earache that stems from a problem in the throat or teeth, which we call referred earache. 

 

During your consultation for ear problems, examination may include one or more of the following:

 

Tuning fork test– this is a basic indicative hearing test, carried out in the clinic room to determine the location of your hearing loss.

Otoscopy-inspection of your outer ears, ear canal and ear drum (tympanic membrane). If needed, ear wax will be removed. In some cases, impacted wax turns out to be the only reason for your hearing loss, removal will then restore it immediately! In case of ear discharge, an ear swab may be carried out before cleaning your ear canal with a small, thin suction.

Tympanometry-a test to determine how your ear drum reacts to varying pressures from outside-a measure for middle ear health and function

Dix-Hallpike test– this is a maneuver that helps diagnose a particular type of vertigo named benign paroxysmal positional vertigo (BPPV). 

Global neurological assessment– this involves examinations such as the Romberg test and Unterberger test, amongst others. These are carried out in the clinic room and require you to stand or walk in a certain position. The results are directly visible and provide us with information about your balance organ, sense of joint position, and possible problems in the brain or other parts of the nervous system.

Audiometry (hearing test)- you will be referred for a hearing test at Nostra Senyora de Meritxell Hospital. Our audiologist will have you listen to various sounds over headphones, and test how well you are able to hear those sounds at different frequencies and intensities. In some cases, a speech recognition test is carried out as well. We will book two appointments: one for the hearing test, and a follow-up appointment at one of our clinics to discuss your results together.

Balance testing– a test to determine whether your balance organ works properly. This will either be performed in the examination room, or you will be referred for more formal balance testing to our audiovestibular center.

Imaging- in a few cases, further investigation of your ear or hearing nerve is needed through either magnetic resonance imaging (MRI) or computed tomography (CT) scanning. This will take place in one of our other clinics. We will book two appointments: one for your scan, and a follow-up appointment at one of our clinics to discuss your results together.