Hearing Loss Reversed by Teeth

When a patient is totally deaf in just one ear (normal hearing on the other side), there are only a few options to help.

• BAHA - Bone Anchored Hearing Aid
• CROS Hearing Aid - Stands for Contralateral Routing Of Signals.

With BAHA, it does require surgery given the hearing aid is literally mounted on a post that is directly drilled into the skull on the deaf ear side. Total cost about $10,000.

With CROS, two hearing aids are required; one on the deaf hear which picks up sound, and another on the good ear where the sound is transmitted to. Total cost about $2,500.

Well, for many folks, having surgery is not palatable and wearing two hearing aids when one ear is perfectly good is also not acceptable.

There's now a third option called SoundBite (cost about $6,800).

With SoundBite, a hearing aid is placed in the deaf ear to pick up sound which is than wirelessly transmitted to a mini-retainer like device placed around the back molars. This special retainer vibrates the teeth which in turn vibrates the skull which sends sound waves to the good ear allowing a patient to hear.

And preliminary results show that patients like it the best among the three options.

However, nothing is all good...

The disadvantage with the SoundBite is battery life. The ear piece battery only lasts about 12-15 hours and the teeth retainer piece about 8 hours. Also, the teeth retainer needs to be fitted by a dentist.

Also, not everybody is a candidate for SoundBite. In order to quality, a patient must have:

1) Good teeth and gums
2) Deaf in only one side with normal hearing on the other. A comprehensive hearing test is required obviously.

Source:

Using Teeth to Help Restore Hearing in One Ear. WSJ 7/10/12

New Video on "Where" Snoring Comes From and Treatment

Our office has produced a new video describing "where" snoring comes from determined by a simple procedure known as sedated or sleep endoscopy.

At its most basic definition, snoring is noise produced from a vibrating mucosal surface in the upper airway.

Though snoring can be defined simply, the tough question is WHERE are these vibrating mucosal surfaces? Because unless one can define WHERE the snoring is coming from, successful treatment can't be pursued definitively.

An office exam performed while a patient is awake is suboptimal as the patient is awake... and not snoring. As such, it is an educated guess where the snoring problem is stemming from.

To this end, there are three main levels where snoring can be produced and the best way to localize a snore is to perform the exam while the patient is asleep (induced by anesthesia) and snoring!

1) Nose
2) Mouth
3) Throat
4) All of the above

Watch the video to see how each of these areas can contribute to a person's snore as well as treatment options.

Bursts of Fast Irregular Clicking Noise in the Ear

Every once in awhile, I see a patient who complains of an irregular clicking (or vibration) noise in the ear that occurs in bursts and may last anywhere from a few minutes every few days to as long as days or weeks at a time.

Click.... click... click, click, click... 

CLICK... click, click... 

click... Click Click... click... ... ... ... CLICK

These irregular clicking noises in the ear should NOT be confused with tinnitus. Rather, irregular clicking noises in the ear are almost always due to muscle spasms... just like "eye twitching" or "facial twitching". BUT, instead of being able to "see" the twitching as with eye twitching, one hears the twitching instead since the muscles are located around or in the ear.

1) Palatal Myoclonus
2) Tensor tympani muscle spasms
3) Stapedius muscle spasms

The first potential cause (palatal myoclonus) can be diagnosed by seeing "spasms" of the soft palate that occurs in time with the clicking. Spasms of the soft palate can be visualized by simply looking in the mouth or by nasal endoscopy. Click here to watch a video of these spasms.

The reason one is able to "hear" the twitching is because the muscles of the soft palate extend up into the ear via the eustachian tube.

Treatment of palatal myoclonus is by botox injections to the muscles that are twitching.

Just like botox treatment anywhere else in the body, the effects are only temporary and needs to be repeated every 3-6 months.

Regarding tensor tympani and stapedius muscle spasms... these muscle are not able to be visualized as they are located within the middle ear. The tensor tympani attaches to the malleus ossicle (the "hammer" of the 3 middle ear bones) and the stapedius muscle attaches to the stapes ossicle (the "stirrup").

Image taken from wikipedia.

Just like any muscle in the body, these muscles can also "twitch" rapidly causing the clicking noise in the ear.

Unfortunately, there is no "test" once can obtain to diagnose this problem with absolute certainty. It is based purely on history and excluding palatal myoclonus as a diagnosis (no soft palate twitching seen even though the patient is able to hear it).

Even more unfortunately, the only way this problem can be treated is surgical... the muscle gets cut. Botox can not be utilized as one needs to be able to "see" or "feel" the muscle in order to inject botox. This surgery is performed by a neuro-otologic surgeon.

See the full list of surgeons who can perform this surgery here.

Read more about this problem here.