Ear surgery is performed for a variety of reasons other than the ear tube (myringotomy) procedure frequently performed by ENT surgeons for chronic middle ear disease. The invention of the operating microscope in the 1950's has been a revolutionary addition to the field of ENT (Oto-rhino-laryngology). It allows excellent and magnified visualization of the very small structures and related anatomy located within the middle and inner ear.

Surgery for Hearing Loss
Surgical reconstructive procedures for correcting certain types of hearing loss, dizziness, and removal of tumors within the extremely small space behind the eardrum are now routinely performed in an outpatient setting. Certain types of hearing loss that previously were not correctible with surgery are now often a relatively simple procedure. Missing, displaced, or diseased middle ear bones (malleus, incus, and stapes) are now replaced, repositioned, or removed and reconstructed with sterile synthetic materials to repair even severe hearing loss to normal levels. There is now an implantable removable external device that allows people with unilateral deafness to hear. This bone anchored hearing aid (BAHA) is made by the Cochlear Company for people who have mixed/conductive hearing loss and unilateral hearing loss or deafness. Those who have chronic draining ears from prior surgery or recurrent infections, or are unable to wear conventional hearing aids due to the severity of hearing loss are also potential candidates for this device. It requires an outpatient surgical procedure in the hospital to install the receiver for the device behind the ear into the mastoid or temporal bone. The removable BAHA device is then attached to allow hearing in the implanted ear. An external test device is placed before surgery is scheduled to give the patient an idea of what the hearing will be like after surgery.The BAHA receiver can be easily removed for athletic activities like swimming or sports like football, wrestling, baseball, hockey,etc. that require headgear or helmet wear. 

Surgery for Disease
Chronic or traumatic holes in the ear drum (tympanic membrane perforation) from infection; disease within the hollow bone (mastoid bone) behind the ear drum; and congenital or aquired cysts (cholesteatoma) that form in the middle ear or mastoid bone all now can be safely corrected with little risk of increased hearing loss or dizziness. These surgeries are called tympanoplasty and tympanomastoidectomy respectively. If the middle ear bones (ossicles) are diseased, that surgery is called an ossicular chain reconstruction (OCR) surgery. Often, one or a combination of these procedures are performed based on the pathology discovered when the middle ear and mastoid  areas are examined with the operating microscope at time of surgery. 

Surgery for Dizziness
There are also specific procedures for chronic dizziness (vertigo) that involve patching or repairing small leaks (perilymphatic fistulas) that occur in the membranes that separate the middle ear from the inner ear. In cases of inner ear disease ( Meniere's Disease), an outpatient or in office procedure that involves periodic injection of certain medicines into the middle ear thru the ear drum; or placing a tube in the eardrum thru which a thin wick is placed near a small membrane that leads into the inner ear. The patient then applies ear drops of the same medicines daily. Both procedures  can be performed in an office setting, often with good response.  For severe intractible cases of unilateral vertigo caused by Meniere's disease or tumor, a combined neurosurgical and otologic procedure may be required to section the involved nerve as it leads from the brainstem to the inner ear. This procedure, however, carries a risk of deafness, continued vertigo, or ringing in the involved ear after surgery.

Any of the above conditions are easily diagnosed and often corrected by seeing an experienced ENT surgeon. Call our office for an appointment if you experience any of the above conditions for an appointment with Dr. Sciacca.

For more information about the BAHA implantable hearing aid 

4501 Southlake Pkwy
Suite #200
Hoover, AL 35244