Related Classes & Events
Wednesday, June 26th, 2013
Tuesday, August 6th, 2013
Saturday, August 10th, 2013
Tuesday, October 1st, 2013
Saturday, November 2nd, 2013
Hearing, Balance, and Posterior Skull Base Disorders
Pittsburgh Ear Associates has provided neuro-otologic care at Allegheny General Hospital for over fifteen years. We provide medical and surgical care for patients with disorders of hearing, balance, facial nerve, and the skull base.
Our health care team allows for advanced comprehensive care of all disorders affecting the ear and balance system. The Neuro-otology division’s clinical service includes:
- Three subspecialty trained Neuro-otologists (specialists trained for disorders of the ear and balance system)
- A full compliment of Audiology professionals
- Comprehensive hearing testing facility including multiple audiometers, tympanometry, otoacoustic emission testing, and modern auditory evoked brainstem responses (Stacked and CHAMP)
- Balance Center with Rotary Chair, ENG, Computerized Dynamic Posturography, ECoG, and VEMP testing.
- A cochlear implant team for appropriate candidate screening, surgery, and post-implantation care.
- Full imaging capability (3 MRI and 2 CT’s at AGH campus alone) with highly specialized Neuroradiologists for advanced imaging diagnosis.
What do we treat?
- Progressive hearing loss (from early hearing loss to profound deafness)
- Sudden hearing losses
- Chronic ear infections (draining, cholesteatoma, ear canal infections)
- Tumors of the ear canal or middle ear
- Positional Vertigo
- Meniere’s disease
- Vestibular neuronitis
- Migraine associated dizziness
- Superior canal dehiscence
- All other causes of imbalance and dizziness
Facial Nerve Disorders
- Facial nerve paralysis
- Bell’s palsy
- Ramsay-Hunt syndrome
Skull Base Tumors
- Acoustic tumors (Vestibular schwannomas)
- All tumors affecting the ear, temporal bone, or posterior fossa
Surgery for the Chronically Infected Ear
Our Division’s expertise ranges from the management of recurrent ear infections to multi-stage tympanoplasty with mastoidectomy for the eradication of cholesteatoma. Surgery for perforated eardrums can be performed at AGH with a variety of techniques, tailored to the situation. Middle ear reconstruction is performed after the eradication of infection to optimize hearing.
Vertigo/ Imbalance Treatment
The most common treatments provided are the canalolith repositioning maneuvers used to treat benign position vertigo and similar conditions. Occasionally posterior canal occlusion is necessary for difficult cases.
Meniere’s disease is treated successfully with medical management in most cases, but a variety of surgical options are available for those that have refractory disease. Endolymphatic sac surgery, intratympanic gentamycin, and vestibular nerve section are all effective treatments depending on patients’ desires and pre-intervention hearing levels.
Constant imbalance often requires the expertise of a physical therapist trained in vestibular rehabilitation techniques. AGH offers these services with highly trained physical therapists that can analyze patients’ balance strategies and suggest appropriate methods to get their balance back to normal.
Most nerve hearing loss actually involves degeneration of hair cells that act to translate sound energy into an electric signal the brain can then interpret. Cochlear implants are a computer processor attached to an electrode which when inserted into the cochlea bypasses the hair cells and stimulates the cochlear nerve directly. Patients even with profound deafness can often hear at normal levels and when properly trained can in most cases talk on a telephone again. We have the surgical expertise for cochlear implant candidate screening and surgical insertion and the audiology expertise for proper programming and rehabilitation.
Hearing amplification devices (hearing aids) have made great strides in the past years with new noise canceling technologies, directional microphones, and strategies to eliminate occlusion effect. These devices remain an important tool for the treatment of neural hearing loss.
Skull Base Surgery/Radiosurgery
Our surgeons specialize in the treatment of complex lesions of the temporal bone. This includes expertise in various approaches to acoustic tumors, meningiomas, and all other tumors affecting this complex anatomic area. Our surgeons are also certified in stereotactic irradiation protocols and work collaboratively with our radiation oncologists at AGH to provide patients with a comprehensive and balanced approach to these complex tumors.
- Kelly Garbolloti, NP
- Renee M. Garvin, AuD., CCC-A
- Robert Hendry, M.A., CCC-A
- Rhonda Tubbs, M.A., CCC-A
- Lawrence McGuinness, M.A., CCC-A
- Julie Hobbs, M.S., CCC-A
- Denise Hoysack., M.A., CCC-A
Clinical Research Trials
Serological diagnosis of autoimmune inner ear disease (AIED)
The diagnosis of auto-immune inner ear disease (AIED) is currently clinical. The etiology is poorly understood as well. Current serologic markers are poorly sensitive and specific. We hypothesize that there are specific proteins that serve as the primary antigens in this disorder. We plan to evaluate auto-immunity to these proteins in AIED and Meniere’s disease (felt to be an immune regulated) with respect to controls.
Prospective blood sample analysis of control patients, patients with Meniere’s disease, and patients with AIED.
Patients with autoimmune inner ear disorder will be recruited. This defined as bilateral severe, steroid responsive hearing loss. In addition patients with Meniere’s disease as established by the American Academy of Otolaryngology-Head and Neck Surgery will be recruited. Control subjects with normal hearing and presbyacusis will be recruited as well.
ARUP Laboratories, Salt Lake City, UT
Todd A. Hillman, MD.
Hydroxyapaptite or Resorbable Plate Cranioplasty Following Acoustic Tumor and Vestibular Nerve Surgery: Is There a Reduction in the Rate of Cerebrospinal Fluid Leaks?
The investigators of this study are examining the possible benefit of using either a mesh plate that is absorbed over time or a type of bone cement to strengthen the closure of the bone following your surgery. The traditional technique uses only fat taken from your abdomen to fill in the holes made in the covering of your brain on the way to your tumor or while cutting your nerve of balance. This technique is proven; however there is up to a one in five chance of having a spinal fluid leak following the surgery with this technique. Most of these leaks can be stopped by placing a lumbar drain (a catheter that temporarily drains the fluid from the area around your spinal cord); however it often requires an additional hospital stay with bed-rest of three to four days. A smaller percent of patients with this complication will need a revision surgery to fix the leak. The aim of this study is to investigate two methods which may help prevent this problem.
Prospective evaluation of patients undergoing plate or hydroxyapatite cranioplasty following acoustic tumor surgery.
Any patient undergoing translabyrinthine approach to acoustic tumor removal qualifies.
Todd A. Hillman, MD